Life Abundant Center

NPI #1063965242 in Bowling Green, Kentucky

Provider Information

NPI Number: 1063965242
Entity Type: Organization
Organization Name: Life Abundant Center
Primary Specialty: Social Worker - Clinical
Enumeration Date: Jul 25, 2016
Last Updated: Jul 25, 2016

Practice Location

Address: 1830 DESTINY LN
Address 2: SUITE105
City: Bowling Green
State: Kentucky
ZIP Code: 42104-1087
Phone: (270) 792-9683

Authorized Official

Name: JAMIE ELIZABETH WALL, LCSW
Title: OWNER
Phone: (270) 792-9683

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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