Provider Demographics
NPI:1871631424
Name:HEALING DYNAMICS INC
Entity Type:Organization
Organization Name:HEALING DYNAMICS INC
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-973-0817
Mailing Address - Street 1:3830 PACKARD ST
Mailing Address - Street 2:250
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2051
Mailing Address - Country:US
Mailing Address - Phone:734-973-0817
Mailing Address - Fax:734-975-2909
Practice Address - Street 1:3830 PACKARD ST
Practice Address - Street 2:250
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2051
Practice Address - Country:US
Practice Address - Phone:734-973-0817
Practice Address - Fax:734-975-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801059658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION79500Medicare ID - Type Unspecified