Organization
INSTITUTE FOR LIFE RENOVATION, LLC
Active
Organization
INSTITUTE FOR LIFE RENOVATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORI EICKLEBERRY PH.D., ABPP (MANAGING PARTNER)
(954) 766-4955
Entity
Organization
Contact information
Practice address
1421 SE 4TH AVE, FORT LAUDERDALE, FL 33316-1940
(954) 766-4955
(954) 616-5147
Mailing address
1421 SE 4TH AVE FL 2, FORT LAUDERDALE, FL 33316-1900
(954) 766-4955
(954) 616-5147
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
06/02/2017
Last updated
11/06/2023
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