Provider Demographics
NPI:1326715566
Name:INTEGRATED BRAINBODY THERAPY LLC, FORMER BRAINWISE THERAPY LLC
Entity Type:Organization
Organization Name:INTEGRATED BRAINBODY THERAPY LLC, FORMER BRAINWISE THERAPY LLC
Other - Org Name:DR. DORIS SCHRANER, LCPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRANER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:702-518-9450
Mailing Address - Street 1:144 S KINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-9432
Mailing Address - Country:US
Mailing Address - Phone:702-518-9450
Mailing Address - Fax:
Practice Address - Street 1:144 S KINGSTON ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-9432
Practice Address - Country:US
Practice Address - Phone:702-518-9450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty