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General NPI Number Information
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NPI Number | 1568170298
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Entity Type | Organization
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Legal Business Name | LIFE RESTORATION AND WELLNESS LLC
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 290 RUBLEIN ST STE F
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City | MARQUETTE
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State | MI
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Zip | 49855-4067
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Country | US
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Telephone | 906-273-0182
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Fax | 877-940-2864
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Provider Business Mailing Address
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Address Line | 1500 W WASHINGTON ST STE 2
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City | MARQUETTE
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State | MI
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Zip | 49855-3196
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Country | US
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Telephone | 906-236-3990
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | MRS. DOROTHY LOWERY
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Credential | LMSW
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Telephone | 906-236-3990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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