Organization
AN AWAKENED HEART PSYCHOLOGICAL APPROACHES TOMENTALHEALTH WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KEESHA MONAIE SULLIVAN LCSW (OWNER)
(727) 692-7364
Entity
Organization
Contact information
Practice address
4100 W KENNEDY BLVD, 327, TAMPA, FL 33609-2288
(727) 692-7364
Mailing address
8450 112TH ST APT 104, SEMINOLE, FL 33772-4221
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW 11227
FL
Other
Enumeration date
06/21/2013
Last updated
07/09/2013
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