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Organization

METAMORPHOSIS LIFE REVITALIZING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. APRIL MICHELLE JACKSON-JAMES PHD (MANAGING PARTNER)
(813) 703-2256
Entity
Organization

Contact information

Practice address
11700 N 58TH ST, SUITE J, TEMPLE TERRACE, FL 33617-1666
(813) 703-2256
Mailing address
8430 MONTRAVAIL CIR, #313, TEMPLE TERRACE, FL 33637-3024
(813) 703-2256
(813) 512-8904

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY8197
FL

Other

Enumeration date
06/20/2014
Last updated
06/20/2014
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