Healthcare Provider Details

I. General information

NPI: 1184310427
Provider Name (Legal Business Name): EMBODY THERAPY AND BIRTH WORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 HOGBACK RD STE 11
ANN ARBOR MI
48105-9752
US

IV. Provider business mailing address

2020 HOGBACK RD STE 11
ANN ARBOR MI
48105-9752
US

V. Phone/Fax

Practice location:
  • Phone: 952-836-4288
  • Fax:
Mailing address:
  • Phone: 952-836-4288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: KAITLIN WRIGHT
Title or Position: OWNER
Credential: LMSW, LICSW
Phone: 952-836-4288