Provider Demographics
NPI:1083397962
Name:BREATHE THERAPY LLC
Entity Type:Organization
Organization Name:BREATHE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASTERS IN SOCIAL WORK
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-930-4112
Mailing Address - Street 1:2311 SHELBY AVE APT 106-D
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3849
Mailing Address - Country:US
Mailing Address - Phone:269-930-4112
Mailing Address - Fax:
Practice Address - Street 1:2311 SHELBY AVE APT 106-D
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3849
Practice Address - Country:US
Practice Address - Phone:269-930-4112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty