Organization
SOMETHING MORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY K LICHTENWALTER PHD (OWNER)
(765) 376-8099
Entity
Organization
Contact information
Practice address
3930 S NOVA RD STE 307, PORT ORANGE, FL 32127-9293
(138) 679-5799
Mailing address
1910 MARILYN ST, DAYTONA BEACH, FL 32118-5123
(765) 376-8099
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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