| NPI | 1215590369 |
|---|---|
| Former Legal Business Name | A FULFILLED LIFE |
| Entity Type | Organization |
| Authorized Contact | FAMOUS ERWN Therapist 772-985-4941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-04-15 |