Organization
LIFES GOOD STAYHERE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEYSHIA FULLER (PRESIDENT)
(704) 441-7205
Entity
Organization
Contact information
Practice address
1048 SCOTCH MEADOWS LOOP, MONROE, NC 28110-9861
(704) 441-7205
Mailing address
1048 SCOTCH MEADOWS LOOP, MONROE, NC 28110-9861
(704) 441-7205
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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