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General NPI Number Information
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NPI Number | 1952215519
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Entity Type | Organization
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Legal Business Name | RESTORED LIFE THERAPY
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 42 E RAHN RD STE 101A
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City | DAYTON
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State | OH
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Zip | 45429-5459
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Country | US
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Telephone | 937-230-8534
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Fax | 326-529-4053
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Provider Business Mailing Address
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Address Line | 42 E RAHN RD STE 101A
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City | DAYTON
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State | OH
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Zip | 45429-5459
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Country | US
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Telephone | 937-230-8534
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Fax | 326-529-4053
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Authorized Official
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Title or Position | OWNER
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Name | KAILYNN VANHOESEN
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Credential | MSW, LISW-S
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Telephone | 937-902-3944
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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 | NULL
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