Organization
TEA OF LIFE HOLISTIC BEHAVIORAL HEALTH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TUNISIA LONDON LICSW, PIP (OWNER)
(251) 401-5602
Entity
Organization
Contact information
Practice address
34124 BURWOOD DR, SPANISH FORT, AL 36527-7301
(251) 401-5602
Mailing address
34124 BURWOOD DR, SPANISH FORT, AL 36527-7301
(251) 401-5602
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/10/2022
Last updated
01/11/2022
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