Healthcare Provider Details

I. General information

NPI: 1275332801
Provider Name (Legal Business Name): SPHAIRA WELLNESS LLC AMY FFIFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 FREEDOM RD STE A
LITTLE CHUTE WI
54140-3200
US

IV. Provider business mailing address

1800 FREEDOM RD STE A
LITTLE CHUTE WI
54140-3200
US

V. Phone/Fax

Practice location:
  • Phone: 920-460-9009
  • Fax:
Mailing address:
  • Phone: 920-460-9009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMY FIFIELD
Title or Position: COUNSELOR/OWNER
Credential: MA LPC
Phone: 920-209-6617