Provider Demographics
NPI:1134543093
Name:THERAPEUTIC HEALING, LLC
Entity type:Organization
Organization Name:THERAPEUTIC HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PILLING
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:262-470-2512
Mailing Address - Street 1:S77W30705 MOSHER DR.
Mailing Address - Street 2:
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149
Mailing Address - Country:US
Mailing Address - Phone:262-470-2512
Mailing Address - Fax:
Practice Address - Street 1:2609 N. GRANDVIEW BLVD.
Practice Address - Street 2:SUITE 150
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188
Practice Address - Country:US
Practice Address - Phone:262-522-8640
Practice Address - Fax:262-522-8640
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERAPEUTIC HEALING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI273-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty