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General NPI Number Information
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NPI Number | 1497553796
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Entity Type | Organization
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Legal Business Name | THE HEALING PATH, LLC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 404 MAIN ST STE A
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City | COTTONWOOD
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State | ID
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Zip | 83522-5270
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Country | US
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Telephone | 208-921-3920
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 103
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City | COTTONWOOD
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State | ID
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Zip | 83522-0103
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Country | US
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Telephone | 208-921-3920
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | HOLLY GRAHAM
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Credential | LCPC
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Telephone | 208-921-3920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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