The Life Source LLC

NPI #1477195154 in Columbus, Georgia

Provider Information

NPI Number
1477195154
Entity Type
Organization
Organization Name
The Life Source LLC
Primary Specialty
Counselor - Professional
Enumeration Date
Oct 14, 2019
Last Updated
Oct 14, 2019

Practice Location

Address
3228 UNIVERSITY AVE STE 103
State
Georgia
ZIP Code
31907-7201
Phone
(762) 207-8218

Authorized Official

Name
LATEASHA SKINNER, LPC
Title
CEO
Phone
(762) 207-8218

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical
Marriage & Family Therapist
Counselor - ProfessionalProfessional

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