Provider Demographics
NPI:1659147320
Name:PAPER CRANES THERAPY
Entity Type:Organization
Organization Name:PAPER CRANES THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LCPC
Authorized Official - Phone:208-719-1854
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-0292
Mailing Address - Country:US
Mailing Address - Phone:208-719-1854
Mailing Address - Fax:
Practice Address - Street 1:120 E LAKE ST STE 305
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1366
Practice Address - Country:US
Practice Address - Phone:208-719-1854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health