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General NPI Number Information
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NPI Number | 1386282416
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Entity Type | Organization
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Legal Business Name | LIFE COMPASS THERAPY, LLC
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Dates
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Enumeration Date | 12/19/2019
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 5226 INDIAN RIVER RD STE 100
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City | VIRGINIA BCH
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State | VA
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Zip | 23464-6179
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Country | US
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Telephone | 757-943-9555
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Fax | 757-664-9494
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Provider Business Mailing Address
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Address Line | 5226 INDIAN RIVER RD STE 100
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City | VIRGINIA BCH
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State | VA
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Zip | 23464-6179
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Country | US
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Telephone | 757-943-9555
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Fax | 757-664-9494
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA ALLEN
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Credential | MA, LMFT,
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Telephone | 757-943-9555
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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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