Organization
BODY MIND HEALING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO VILLALOBOS LPC (OWNER/PSYCHOTHERAPIST)
(202) 297-2825
Entity
Organization
Contact information
Practice address
1712 OSBORNE RD STE L, SAINT MARYS, GA 31558-9103
(912) 673-9901
Mailing address
602 E BAY AVE, KINGSLAND, GA 31548-5228
(202) 297-2825
(912) 882-3303
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC008911
GA
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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