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General NPI Number Information
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NPI Number | 1386506194
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Entity Type | Organization
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Legal Business Name | AUTHENTIC HEALING THERAPY, LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1001 OFFICE PARK RD STE 115B
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2509
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Country | US
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Telephone | 515-518-0583
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 OFFICE PARK RD STE 115B
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2509
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Country | US
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Telephone | 515-518-0583
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | AMANDA ACKERMAN
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Credential | MA
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Telephone | 515-238-6312
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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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