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General NPI Number Information
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NPI Number | 1750151064
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Entity Type | Organization
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Legal Business Name | TOTAL LIFE CHANGE COUNSELING, LLC.
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 1800 GURNEE AVE
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City | ANNISTON
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State | AL
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Zip | 36201-3731
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Country | US
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Telephone | 251-308-1919
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 284
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City | JACKSONVILLE
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State | AL
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Zip | 36265-0284
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Country | US
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Telephone | 251-308-1919
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDRA CUNNINGHAM
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Credential |
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Telephone | 251-308-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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