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General NPI Number Information
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NPI Number | 1003550575
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Entity Type | Organization
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Legal Business Name | BREATH OF GRACE WELLNESS
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 404 PUBLIC SQ
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City | COLUMBIA
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State | KY
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Zip | 42728-1458
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Country | US
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Telephone | 270-634-9346
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Fax |
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Provider Business Mailing Address
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Address Line | 404 PUBLIC SQ BREATH OF GRACE WELLNESS PO BOX 1061
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City | COLUMBIA
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State | KY
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Zip | 42728-1458
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Country | US
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Telephone | 270-634-9346
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Fax | 270-751-0020
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY N PRIDDY
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Credential | LPCC
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Telephone | 270-634-9346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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