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General NPI Number Information
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NPI Number | 1538533856
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Entity Type | Organization
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Legal Business Name | WHOLE LIFE THERAPY LLC
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 239 W CARLETON RD
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City | HILLSDALE
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State | MI
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Zip | 49242-5033
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Country | US
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Telephone | 517-610-6816
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Fax | 517-721-7870
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Provider Business Mailing Address
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Address Line | 239 W CARLTON RD
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City | HILLSDALE
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State | MI
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Zip | 49242
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Country | US
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Telephone | 517-610-6816
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Fax | 517-721-7870
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | LORETTA ANN BOBZIEN
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Credential | LMSW CAADC
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Telephone | 517-610-6816
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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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