| NPI | 1578291449 |
|---|---|
| Doing Business As | THE LIGHT SOURCE CENTER FOR HEALING |
| Entity Type | Organization |
| Authorized Contact | SHERRY SMITH Owner 980-208-8598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2022-08-09 |