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General NPI Number Information
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NPI Number | 1043620305
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Entity Type | Organization
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Legal Business Name | OUR WHOLE LIVES, PLLC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 619 OAKLAND ST
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-3645
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Country | US
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Telephone | 828-243-6703
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Fax | 828-595-4300
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Provider Business Mailing Address
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Address Line | 619 OAKLAND ST
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-3645
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Country | US
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Telephone | 828-243-6703
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Fax | 828-595-4300
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Authorized Official
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Title or Position | OWNER, MANAGER
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Name | KATHI JO BIVENS
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Credential | LPC
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Telephone | 828-243-6703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 10521
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License Number State | NC
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