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General NPI Number Information
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NPI Number | 1780083451
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Entity Type | Organization
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Legal Business Name | HEALING WITH HEART AND HORSES THERAPY PRACTICE LLC
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 133 FRANKLIN CORNER RD 2ND FLOOR SUITE 2-PSYCHOTHERAPY AT THE ATRIUM
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2531
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Country | US
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Telephone | 609-937-5881
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Fax | 609-406-9319
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Provider Business Mailing Address
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Address Line | 9 SHEFFIELD RD
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City | EAST WINDSOR
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State | NJ
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Zip | 08520-1707
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Country | US
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Telephone | 609-937-5881
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Fax | 609-406-9319
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. DIANE MCMAHON
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Credential | EDS, LPC, RN
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Telephone | 609-937-5881
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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 | 37PC00374900
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License Number State | NJ
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