Modern Soul Therapy LLC
NPI #1013516145 in Quincy, Massachusetts
Provider Information
- NPI Number
- 1013516145
- Entity Type
- Organization
- Organization Name
- Modern Soul Therapy LLC
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Oct 20, 2020
- Last Updated
- Feb 10, 2025
Practice Location
- Address
- 120 WHITWELL ST UNIT D-106
- City
- Quincy
- State
- Massachusetts
- ZIP Code
- 02169-1998
- Phone
- (740) 408-6407
Authorized Official
- Name
- MALLORY A INGRAM, LMHC, LCPC
- Title
- OWNER
- Phone
- (740) 408-6407
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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