Organization
EXPERIENTIAL HEALING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ETHEL YOUNGREN (OFFICE MANAGER)
(901) 372-0710
Entity
Organization
Contact information
Practice address
1713 LOCKETT PL, MEMPHIS, TN 38104-3923
(901) 372-0710
Mailing address
1713 LOCKETT PL, MEMPHIS, TN 38104-3923
(901) 372-0710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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