Provider Demographics
NPI:1700112810
Name:HEALING SOULS THERAPY
Entity type:Organization
Organization Name:HEALING SOULS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:651-490-1874
Mailing Address - Street 1:2903 EDGERTON ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55117-1205
Mailing Address - Country:US
Mailing Address - Phone:651-490-1874
Mailing Address - Fax:651-490-1874
Practice Address - Street 1:2903 EDGERTON ST
Practice Address - Street 2:
Practice Address - City:LITTLE CANADA
Practice Address - State:MN
Practice Address - Zip Code:55117-1205
Practice Address - Country:US
Practice Address - Phone:651-490-1874
Practice Address - Fax:651-490-1874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100670261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8G213HEOtherBLUE CROSS BLUE SHIELD