INTELLECTUALSOUL CLINICAL CONSULTING, LLC

MONTGOMERY, AL
NPI1912559675
Entity TypeOrganization
Authorized ContactSTEPHAN IDRIS MAMBAZO
Owner/Primary Provider
334-625-9617
Organization Subpart ?No
Primary Taxonomy251S00000X 
Enumeration Date2019-07-12
Last Update Date2021-03-12
Business Address
INTELLECTUALSOUL CLINICAL CONSULTING, LLC
2541 COLLEGE ST
MONTGOMERY, AL 36106-2124
Phone number: 334-207-7657
Mailing Address
INTELLECTUALSOUL CLINICAL CONSULTING, LLC
2541 COLLEGE ST
MONTGOMERY, AL 36106-2124
Phone number: 334-207-7657
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