Provider Demographics
NPI:1346923356
Name:INTROSPECTIVE HEALTH PLLC
Entity Type:Organization
Organization Name:INTROSPECTIVE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANI
Authorized Official - Middle Name:M
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:509-601-3827
Mailing Address - Street 1:22723 E PARK BEACH RD
Mailing Address - Street 2:
Mailing Address - City:NEWMAN LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99025-9470
Mailing Address - Country:US
Mailing Address - Phone:509-601-3827
Mailing Address - Fax:
Practice Address - Street 1:1421 N MEADOWWOOD LN STE 72
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-6020
Practice Address - Country:US
Practice Address - Phone:509-601-3827
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