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General NPI Number Information
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NPI Number | 1134543093
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC HEALING, LLC
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 2609 N. GRANDVIEW BLVD. SUITE 150
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City | WAUKESHA
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State | WI
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Zip | 53188
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Country | US
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Telephone | 262-522-8640
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Fax | 262-522-8640
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Provider Business Mailing Address
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Address Line | S77W30705 MOSHER DR.
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City | MUKWONAGO
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State | WI
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Zip | 53149
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Country | US
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Telephone | 262-470-2512
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JANETTE MARIE PILLING
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Credential | OT
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Telephone | 262-470-2512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 273-26
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License Number State | WI
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