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General NPI Number Information
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NPI Number | 1073476214
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Entity Type | Organization
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Legal Business Name | HEALING GARDEN, LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 13805 GALWAY SAND RD
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City | RIVERVIEW
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State | FL
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Zip | 33579-3204
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Country | US
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Telephone | 727-422-7826
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 727-422-7826
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | JAMILA TIPPIT
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Credential | LMFT
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Telephone | 813-474-8180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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