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General NPI Number Information
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NPI Number | 1679654487
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Entity Type | Organization
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Legal Business Name | GETALIFE, LLC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6817 SOUTHPOINT PKWY STE 904 904
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6293
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Country | US
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Telephone | 904-332-9100
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Fax | 904-482-0647
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Provider Business Mailing Address
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Address Line | 6817 SOUTHPOINT PKWY STE 904 904
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6293
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Country | US
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Telephone | 904-332-9100
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Fax | 904-482-0647
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KELLY BOSWELL
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Credential | PH.D.
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Telephone | 904-332-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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