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General NPI Number Information
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NPI Number | 1104357326
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Entity Type | Organization
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Legal Business Name | LIFE AND LOVE COUNSELING LLC
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 205 GRANITE RUN DR SUITE 310
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City | LANCASTER
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State | PA
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Zip | 17601-6821
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Country | US
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Telephone | 717-917-5862
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Fax |
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Provider Business Mailing Address
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Address Line | 205 GRANITE RUN DR SUITE 310
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City | LANCASTER
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State | PA
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Zip | 17601-6821
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Country | US
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Telephone | 717-917-5862
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBRE LEI WITTE
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Credential | LSW
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Telephone | 717-917-5862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW129118
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License Number State | PA
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