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General NPI Number Information
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NPI Number | 1992337778
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Entity Type | Organization
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Legal Business Name | TRANSFORM YOUR BIRTH, LLC
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 677 CRAIG RD STE 208
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City | CREVE COEUR
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State | MO
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Zip | 63141-7125
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Country | US
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Telephone | 636-699-2839
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Fax | 844-641-1015
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Provider Business Mailing Address
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Address Line | 677 CRAIG RD STE 208
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City | CREVE COEUR
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State | MO
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Zip | 63141-7125
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Country | US
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Telephone | 636-699-2839
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Fax | 844-641-1015
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Authorized Official
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Title or Position | THERAPIST
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Name | JAMIE BODILY
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Credential | MS, LPC
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Telephone | 636-699-2839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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