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General NPI Number Information
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NPI Number | 1437458791
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Entity Type | Organization
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Legal Business Name | LIFEPATH, PLLC
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 2820 LAWNDALE DR STE 112 BOX 12
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City | GREENSBORO
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State | NC
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Zip | 27408-4127
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Country | US
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Telephone | 336-542-5777
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Fax | 336-542-5777
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Provider Business Mailing Address
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Address Line | 2820 LAWNDALE DR STE 112 BOX 12
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City | GREENSBORO
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State | NC
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Zip | 27408-4127
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Country | US
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Telephone | 336-542-5777
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Fax | 336-542-5777
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Authorized Official
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Title or Position | OWNER
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Name | THERESHA RENEE HILL
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Credential | LCSW
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Telephone | 336-255-3367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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