Provider Demographics
NPI:1225626682
Name:EMOTIONAL FITNESS LLC
Entity Type:Organization
Organization Name:EMOTIONAL FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:334-521-2155
Mailing Address - Street 1:158 S DEBARDELEBEN ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5520
Mailing Address - Country:US
Mailing Address - Phone:334-521-2155
Mailing Address - Fax:
Practice Address - Street 1:158 S DEBARDELEBEN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5520
Practice Address - Country:US
Practice Address - Phone:334-521-2155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty