| Blue Leaf Therapy | |
|
1828 S Florida Ave Lakeland FL 33803-2654 | |
| (863) 272-9633 | |
| Not Available |
| Full Name | Blue Leaf Therapy |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1828 S Florida Ave, Lakeland, Florida |
| Authorized Official Name and Position | Ellie N Choate (THERAPIST) |
| Authorized Official Contact | 7176093626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Leaf Therapy 1045 S New York Ave Lakeland FL 33803-1216 Ph: (717) 609-3626 | Blue Leaf Therapy 1828 S Florida Ave Lakeland FL 33803-2654 Ph: (863) 272-9633 |
| NPI Number | 1790563740 |
|---|---|
| Provider Enumeration Date | 09/20/2023 |
| Last Update Date | 01/05/2024 |
| Certification Date | 01/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790563740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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