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General NPI Number Information
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NPI Number | 1528848181
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Entity Type | Organization
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Legal Business Name | JOYFUL RAINE THERAPY AND HOLISTIC CARE LLC
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 512 SCHOOLCRAFT RD
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City | MARQUETTE
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State | MI
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Zip | 49855
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Country | US
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Telephone | 906-299-3208
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Fax | 906-257-6736
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Provider Business Mailing Address
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Address Line | 512 SCHOOLCRAFT RD
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City | MARQUETTE
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State | MI
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Zip | 49855-5243
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Country | US
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Telephone | 906-299-3208
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Fax | 906-257-6736
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. JYOTISH WIERTELLA
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Credential | LMSW
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Telephone | 906-299-3208
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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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