Healthcare Provider Details
I. General information
NPI: 1255115580
Provider Name (Legal Business Name): EXHALE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2023
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17245 WILLIAM ST
LANSING IL
60438-1382
US
IV. Provider business mailing address
18125 ROY ST UNIT 607
LANSING IL
60438-6654
US
V. Phone/Fax
- Phone: 312-593-1879
- Fax:
- Phone: 312-593-1879
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALTHIA
GAYLE
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 312-593-1879