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General NPI Number Information
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NPI Number | 1225736267
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Entity Type | Organization
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Legal Business Name | PATH TO HEALING AND WELLNESS PLLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 400 5TH ST STE 192
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City | PERU
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State | IL
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Zip | 61354-2876
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Country | US
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Telephone | 815-303-0718
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Fax |
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Provider Business Mailing Address
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Address Line | 400 5TH ST STE 192
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City | PERU
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State | IL
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Zip | 61354-2876
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Country | US
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Telephone | 815-310-0718
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KIMBERLY MERCER
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Credential | LMFT
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Telephone | 815-310-0718
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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 |
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License Number State |
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