Integrative Mind Body Therapy, LLC
NPI #1407594153 in Charleston, South Carolina
Provider Information
- NPI Number
- 1407594153
- Entity Type
- Organization
- Organization Name
- Integrative Mind Body Therapy, LLC
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- May 23, 2022
- Last Updated
- Nov 1, 2023
Practice Location
- Address
- 2511 STADIUM DR
- City
- Charleston
- State
- South Carolina
- ZIP Code
- 29406-6606
- Phone
- (816) 752-6631
Authorized Official
- Name
- MS. LISA FRACICA, LCPC
- Title
- OWNER AND SOLE MEMBER
- Phone
- (816) 752-6631
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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