| Entity Name: | SWAN CITY PSYCHOLOGY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 21 May 2024 (9 months ago) |
| Document Number: | P24000036135 |
| Address: | 2840 SEYMORE ST, LAKELAND, FL 33813 |
| Mail Address: | 2840 SEYMORE ST, LAKELAND, FL 33813 |
| ZIP code: | 33813 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518701853 | 2024-06-21 | 2024-09-12 | 2840 SEYMORE ST, LAKELAND, FL, 338133761, US | 1815 CRYSTAL LAKE DR # 1409, LAKELAND, FL, 338015979, US | |||||||||||||
|
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| Phone | +1 863-640-9080 |
Authorized person
| Name | KRISTIN C MULLER |
| Role | OWNER |
| Phone | 8636409080 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| MULLER K, RISTIN C | President | 2840 SEYMORE ST, LAKELAND, FL 33813 |
| Name | Role | Address |
|---|---|---|
| MULLER K, RISTIN C | Secretary | 2840 SEYMORE ST, LAKELAND, FL 33813 |
| Name | Role | Address |
|---|---|---|
| MULLER K, RISTIN C | Treasurer | 2840 SEYMORE ST, LAKELAND, FL 33813 |
| Name | Role | Address |
|---|---|---|
| MULLER K, RISTIN C | Director | 2840 SEYMORE ST, LAKELAND, FL 33813 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-05-21 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
