| Life Untangled Therapy Llc | |
|
9108 Church St # 308 Manassas VA 20110-9997 | |
| (703) 686-8728 | |
| (703) 775-1458 |
| Full Name | Life Untangled Therapy Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 9108 Church St # 308, Manassas, Virginia |
| Authorized Official Name and Position | Jamie Hardy (SOLE OWNER) |
| Authorized Official Contact | 7036868728 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Untangled Therapy Llc 9108 Church St # 308 Manassas VA 20110-9997 Ph: (703) 686-8728 | Life Untangled Therapy Llc 9108 Church St # 308 Manassas VA 20110-9997 Ph: (703) 686-8728 |
| NPI Number | 1588367171 |
|---|---|
| Provider Enumeration Date | 03/23/2023 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588367171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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