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General NPI Number Information
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NPI Number | 1821505389
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Entity Type | Organization
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Legal Business Name | FREEDOM BOUND HEALTH COUNSELING, LLC
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 352 CENTER STREET SUITE 218
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City | MIAMIVILLE
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State | OH
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Zip | 45147-0218
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Country | US
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Telephone | 513-722-5694
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Fax |
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Provider Business Mailing Address
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Address Line | 352 CENTER STREET SUITE 218
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City | MIAMIVILLE
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State | OH
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Zip | 45147-0218
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Country | US
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Telephone | 513-722-5694
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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. KIMBERLY PODRATZ
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Credential | LPCC
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Telephone | 513-722-5694
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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 | E.0700354
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License Number State | OH
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