Organization
INTEGRATIVE MIND BODY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA FRACICA LCPC (OWNER AND SOLE MEMBER)
(816) 752-6631
Entity
Organization
Contact information
Practice address
2511 STADIUM DR, CHARLESTON, SC 29406-6606
(816) 752-6631
(844) 919-1630
Mailing address
2511 STADIUM DR, CHARLESTON, SC 29406-6606
(816) 752-6631
(844) 919-1630
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/23/2022
Last updated
11/01/2023
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