Organization
MY QUALITY LIFE COUNSELING, LLC
Active
Other names
My Quality Life Counseling, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA M. RUNZO LPC, LMFT (THERAPIST AND OWNER)
(719) 695-0757
Entity
Organization
Contact information
Practice address
1864 WOODMOOR DR STE 202, MONUMENT, CO 80132-7464
(719) 695-0757
(719) 532-9576
Mailing address
1864 WOODMOOR DR STE 202, MONUMENT, CO 80132-7464
(719) 695-0757
(719) 532-9576
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFT.0001193
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000163731
—
CO
Enumeration date
08/15/2018
Last updated
08/15/2018
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