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General NPI Number Information
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NPI Number | 1396608337
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Entity Type | Organization
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Legal Business Name | LIGHT OF ONE'S LIFE LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 4531 WHITE BAY CIR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-5056
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Country | US
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Telephone | 813-702-9460
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Fax |
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Provider Business Mailing Address
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Address Line | 4531 WHITE BAY CIR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-5056
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Country | US
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Telephone | 813-702-9460
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRANDY COLBERT
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Credential |
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Telephone | 813-479-8398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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