Provider Demographics
NPI:1811536782
Name:WHOLE BODY HEALING, LLC
Entity Type:Organization
Organization Name:WHOLE BODY HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-515-1515
Mailing Address - Street 1:1200 HIGH ST STE 160
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3222
Mailing Address - Country:US
Mailing Address - Phone:541-515-1515
Mailing Address - Fax:
Practice Address - Street 1:1200 HIGH ST STE 160
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3222
Practice Address - Country:US
Practice Address - Phone:541-515-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty