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General NPI Number Information
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NPI Number | 1609522887
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Entity Type | Organization
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Legal Business Name | THE ZEN THERAPY ROOM LLC
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 171 SANTA FE LN
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-1624
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Country | US
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Telephone | 630-334-7858
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Fax |
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Provider Business Mailing Address
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Address Line | 171 SANTA FE LN
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-1624
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Country | US
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Telephone | 630-601-8660
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CATHERINE WATKINS
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Credential |
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Telephone | 630-601-8660
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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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