| Life Abundant Center | |
|
1830 Destiny Ln Suite105 Bowling Green KY 42104-1087 | |
| (270) 792-9683 | |
| Not Available |
| Full Name | Life Abundant Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1830 Destiny Ln, Bowling Green, Kentucky |
| Authorized Official Name and Position | Jamie Elizabeth Wall (OWNER) |
| Authorized Official Contact | 2707929683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Abundant Center 1830 Destiny Ln Suite105 Bowling Green KY 42104-1087 Ph: () - | Life Abundant Center 1830 Destiny Ln Suite105 Bowling Green KY 42104-1087 Ph: (270) 792-9683 |
| NPI Number | 1063965242 |
|---|---|
| Provider Enumeration Date | 07/25/2016 |
| Last Update Date | 07/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063965242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3483 (Kentucky) | Primary |
News Archive
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