Provider Demographics
NPI:1881422418
Name:YOUR LIFE ARCHITECT LLC
Entity type:Organization
Organization Name:YOUR LIFE ARCHITECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIHOMIROVA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-348-7879
Mailing Address - Street 1:1086 PERSIMMON DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-9068
Mailing Address - Country:US
Mailing Address - Phone:757-348-7879
Mailing Address - Fax:
Practice Address - Street 1:1086 PERSIMMON DR
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-9068
Practice Address - Country:US
Practice Address - Phone:757-348-7879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health