Organization
SPRING OF LIVING WATER COUNSELING, LLC
Active
Other names
NONE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EGUENEL LOUIS LMHC (OWNER)
(561) 670-8825
Entity
Organization
Contact information
Practice address
1814 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5545
(561) 670-8825
Mailing address
PO BOX 9571, PORT ST LUCIE, FL 34985-9571
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/01/2020
Last updated
02/01/2020
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