Provider Demographics
NPI:1639781750
Name:BREATHELIFE THERAPY THAT HEALS LLC
Entity Type:Organization
Organization Name:BREATHELIFE THERAPY THAT HEALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLON
Authorized Official - Suffix:
Authorized Official - Credentials:T-LMFT
Authorized Official - Phone:316-461-6603
Mailing Address - Street 1:10514 W MAY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-1258
Mailing Address - Country:US
Mailing Address - Phone:316-461-6603
Mailing Address - Fax:
Practice Address - Street 1:7200 W 13TH ST N STE 103
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2943
Practice Address - Country:US
Practice Address - Phone:316-461-6603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty