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Organization

MODERN LIFE COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA SULLIVAN (OWNER)
(813) 376-9700
Entity
Organization

Contact information

Practice address
13902 N DALE MABRY HWY, SUITE 240, TAMPA, FL 33618-2428
(813) 376-9700
(813) 936-3585
Mailing address
13902 N DALE MABRY HWY, SUITE 230, TAMPA, FL 33618-2428
(813) 376-9700
(813) 936-3585

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
09/05/2019
Last updated
09/05/2019
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