Provider Demographics
NPI:1538533856
Name:WHOLE LIFE THERAPY LLC
Entity type:Organization
Organization Name:WHOLE LIFE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BOBZIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW CAADC
Authorized Official - Phone:517-610-6816
Mailing Address - Street 1:239 W CARLTON RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242
Mailing Address - Country:US
Mailing Address - Phone:517-610-6816
Mailing Address - Fax:517-721-7870
Practice Address - Street 1:239 W CARLETON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-5033
Practice Address - Country:US
Practice Address - Phone:517-610-6816
Practice Address - Fax:517-721-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health