Provider Demographics
NPI:1457093965
Name:INTEGRATIVE HEALING THERAPIES LLC
Entity Type:Organization
Organization Name:INTEGRATIVE HEALING THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BUCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CLT
Authorized Official - Phone:402-332-7025
Mailing Address - Street 1:12702 WESTPORT PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-4012
Mailing Address - Country:US
Mailing Address - Phone:402-332-7025
Mailing Address - Fax:402-226-8808
Practice Address - Street 1:12702 WESTPORT PKWY STE 101
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68138-4012
Practice Address - Country:US
Practice Address - Phone:402-332-7025
Practice Address - Fax:402-226-8808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty