Organization
THERALOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE ELLIS LMHC (MGR)
(904) 515-2370
Entity
Organization
Contact information
Practice address
4300 MARSH LANDING BLVD, SUITE 204, JACKSONVILLE BEACH, FL 32250
(904) 515-2050
Mailing address
1015 ATLANTIC BLVD STE 161, ATLANTIC BEACH, FL 32233-3313
(904) 515-2370
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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