| Soul Spark Therapy Llc | |
|
140 Sepp Rd Debary FL 32713-3914 | |
| (407) 588-7244 | |
| Not Available |
| Full Name | Soul Spark Therapy Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 140 Sepp Rd, Debary, Florida |
| Authorized Official Name and Position | Rebecca Ruh (LICENSED MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 4075887244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Spark Therapy Llc 1317 Edgewater Dr # 1732 Orlando FL 32804-6350 Ph: () - | Soul Spark Therapy Llc 140 Sepp Rd Debary FL 32713-3914 Ph: (407) 588-7244 |
| NPI Number | 1699512681 |
|---|---|
| Provider Enumeration Date | 07/09/2024 |
| Last Update Date | 07/09/2024 |
| Certification Date | 07/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699512681 | NPI | - | NPPES |
| 1669236212 | Other | FL | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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