Provider Demographics
NPI:1225642648
Name:VISUALIZE YOUR LIFE FAMILY COUNSELING & WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:VISUALIZE YOUR LIFE FAMILY COUNSELING & WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:SHAREESE
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-585-3034
Mailing Address - Street 1:9717 ELK GROVE FLORIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2262
Mailing Address - Country:US
Mailing Address - Phone:916-585-3034
Mailing Address - Fax:
Practice Address - Street 1:9717 ELK GROVE FLORIN RD STE A
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2262
Practice Address - Country:US
Practice Address - Phone:916-585-3034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty