Provider Demographics
NPI:1538708847
Name:HOLISTIC HEALING THERAPY
Entity type:Organization
Organization Name:HOLISTIC HEALING THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:BUSHARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:541-226-9088
Mailing Address - Street 1:777 NE 7TH ST STE 216
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1632
Mailing Address - Country:US
Mailing Address - Phone:541-373-7088
Mailing Address - Fax:
Practice Address - Street 1:777 NE 7TH ST STE 216
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1632
Practice Address - Country:US
Practice Address - Phone:541-373-7088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty