Provider Demographics
NPI:1467166884
Name:WHOLE LIFE HEALTHY
Entity Type:Organization
Organization Name:WHOLE LIFE HEALTHY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN MARIE
Authorized Official - Middle Name:ALLIANO
Authorized Official - Last Name:DUNDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MSOTR/L
Authorized Official - Phone:732-513-6953
Mailing Address - Street 1:3405 NW MAXINE CIR
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3727
Mailing Address - Country:US
Mailing Address - Phone:732-513-6953
Mailing Address - Fax:
Practice Address - Street 1:3405 NW MAXINE CIR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3727
Practice Address - Country:US
Practice Address - Phone:732-513-6953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty