| NPI | 1053878108 |
|---|---|
| Former Legal Business Name | SOULCIAL SANCTUARY,LLC |
| Entity Type | Organization |
| Authorized Contact | CHARLETTE THOMAS Therapy/Mediation 407-791-9693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-03-04 |