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NPI 1285426940

NPI 1285426940 : KAHI THERAPY AND WELLNESS LLC : JOPLIN, MO

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General NPI Number Information
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    NPI Number           |    1285426940
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    Entity Type          |    Organization 
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    Legal Business Name  |    KAHI THERAPY AND WELLNESS LLC 
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Dates
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    Enumeration Date     |    05/20/2025
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    Last Update Date     |    05/20/2025
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Provider Practice Location Address
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    Address Line         |    1627 W 26TH ST 
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    City                 |    JOPLIN
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    State                |    MO
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    Zip                  |    64804-0398
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    Country              |    US
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    Telephone            |    417-627-9601
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    Fax                  |    417-627-9032
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Provider Business Mailing Address
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    Address Line         |    1627 W 26TH ST 
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    City                 |    JOPLIN
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    State                |    MO
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    Zip                  |    64804-0398
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    Country              |    US
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    Telephone            |    417-627-9601
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    Fax                  |    417-627-9032
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     HEATHER  PETERSON 
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    Credential           |    LCSW
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    Telephone            |    417-627-9601
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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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