Life Dance INC
NPI #1104905348 in Gainesville, Florida
Provider Information
- NPI Number
- 1104905348
- Entity Type
- Organization
- Organization Name
- Life Dance INC
- Primary Specialty
- Psychologist - Clinical
- Enumeration Date
- Nov 6, 2006
- Last Updated
- Aug 5, 2014
Practice Location
- Address
- 6417 NW 37TH DR
- City
- Gainesville
- State
- Florida
- ZIP Code
- 32653-0868
- Phone
- (352) 335-1240
Authorized Official
- Name
- DR. MARK A MANUEL, PSY.D.
- Title
- PRESIDENT
- Phone
- (352) 335-1240
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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