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General NPI Number Information
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NPI Number | 1346902210
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Entity Type | Organization
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Legal Business Name | LOTUS EXPERIENCE, LLC
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Dates
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Enumeration Date | 10/08/2021
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 2301 N 9TH ST # 403
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City | PHILADELPHIA
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State | PA
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Zip | 19133-1506
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Country | US
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Telephone | 267-983-8802
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 N 9TH ST # 403
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City | PHILADELPHIA
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State | PA
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Zip | 19133-1506
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Country | US
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Telephone | 267-983-8802
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NAKIRA DARDEN
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Credential | PC
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Telephone | 267-671-5550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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