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General NPI Number Information
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NPI Number | 1427803311
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Entity Type | Organization
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Legal Business Name | HEALING & RESTORATIVE THERAPIES INC
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 1735 W STATE OF FRANKLIN RD STE 5X270
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6573
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Country | US
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Telephone | 423-833-3652
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 W STATE OF FRANKLIN RD STE 5 PB 270
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City | JOHNSON CITY
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State | TN
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Zip | 37604
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Country | US
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Telephone | 423-620-3390
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | ALICIA FRASURE
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Credential | FNP-BC, PMHNP-BC
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Telephone | 423-833-3652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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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 | 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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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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