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General NPI Number Information
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NPI Number | 1639708183
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Entity Type | Organization
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Legal Business Name | HEALING HEARTS TRAUMA THERAPY LLC
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 2689 ANDROS LN
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City | KISSIMMEE
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State | FL
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Zip | 34747-1808
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Country | US
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Telephone | 772-773-0065
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Fax | 949-655-5979
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Provider Business Mailing Address
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Address Line | 10922 SCHUETZ RD
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City | SAINT LOUIS
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State | MO
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Zip | 63146-5704
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Country | US
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Telephone | 772-773-0065
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Fax | 949-655-5979
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Authorized Official
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Title or Position | CEO
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Name | SHARNITA WHITE
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Credential |
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Telephone | 813-557-4701
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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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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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