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General NPI Number Information
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NPI Number | 1154092369
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Entity Type | Organization
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Legal Business Name | INNER PEACE THERAPY LLC
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 420 MAIN ST
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City | LAFAYETTE
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State | IN
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Zip | 47901-1326
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Country | US
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Telephone | 765-202-2574
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 566
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City | DELPHI
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State | IN
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Zip | 46923-0566
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE MILAN
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Credential |
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Telephone | 765-388-9560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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