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General NPI Number Information
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NPI Number | 1417844358
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Entity Type | Organization
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Legal Business Name | YOUPHORIA3, LLC
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 800 WISCONSIN ST BLDG D02
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City | EAU CLAIRE
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State | WI
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Zip | 54703-3588
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Country | US
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Telephone | 715-529-0980
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Fax |
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Provider Business Mailing Address
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Address Line | E1750 SPRUCE RD
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City | ELEVA
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State | WI
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Zip | 54738-9074
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Country | US
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Telephone | 715-529-0980
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CYDNEY M PETERSON
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Credential |
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Telephone | 715-529-0980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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