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NPI 1033935754

NPI 1033935754 : FIVE STONES THERAPY, LLC : BELLBROOK, OH

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General NPI Number Information
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    NPI Number           |    1033935754
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    Entity Type          |    Organization 
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    Legal Business Name  |    FIVE STONES THERAPY, LLC 
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Dates
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    Enumeration Date     |    11/26/2024
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    Last Update Date     |    11/26/2024
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Provider Practice Location Address
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    Address Line         |    1930 N LAKEMAN DR STE 106 
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    City                 |    BELLBROOK
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    State                |    OH
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    Zip                  |    45305-1200
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    Country              |    US
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    Telephone            |    937-502-1141
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    Fax                  |    937-202-4464
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Provider Business Mailing Address
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    Address Line         |    1930 N LAKEMAN DR STE 106 
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    City                 |    BELLBROOK
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    State                |    OH
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    Zip                  |    45305-1200
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    Country              |    US
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    Telephone            |    937-502-1141
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    Fax                  |    937-202-4464
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     BONITA  ASHE 
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    Credential           |    LPCC
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    Telephone            |    937-502-1141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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