Organization
SOULSTICE THERAPEUTIC SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICAH S. HENDRICKSON LMHC (OWNER)
(863) 773-6573
Entity
Organization
Contact information
Practice address
901 W MAIN ST STE 121, WAUCHULA, FL 33873-2532
(863) 773-6573
Mailing address
PO BOX 577, WAUCHULA, FL 33873-0577
(863) 773-6573
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MH13683
FL
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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