Organization
RESTORE LYFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HANNAH KAREN ENGLAND MASTERS (OWNER)
(520) 709-9163
Entity
Organization
Contact information
Practice address
22 CHADWICK DR, STAFFORD, VA 22556-4622
(571) 501-7151
Mailing address
22 CHADWICK DR, STAFFORD, VA 22556-4622
(571) 501-7151
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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