Lifespark Pllc

NPI #1396217816 in Gallatin, Tennessee

Provider Information

NPI Number: 1396217816
Entity Type: Organization
Organization Name: Lifespark Pllc
Primary Specialty: Psychologist - Clinical
Enumeration Date: Dec 21, 2018
Last Updated: Sep 9, 2019

Practice Location

Address: 106 PUBLIC SQ STE 105
City: Gallatin
State: Tennessee
ZIP Code: 37066
Phone: (615) 675-0025

Authorized Official

Name: DR. JASON HOLLAND, PHD
Title: CEO
Phone: (415) 702-8240

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Adult Development & Aging — Adult Development & Aging	103TA0700X
Psychologist - Forensic — Forensic	103TF0200X
Psychologist - Clinical — Clinical	103TC0700X	Primary

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