Provider Demographics
NPI:1336675479
Name:HEALTHY SELF. HEALTHY LIFE., PLLC
Entity Type:Organization
Organization Name:HEALTHY SELF. HEALTHY LIFE., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:JV
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:303-495-6991
Mailing Address - Street 1:3845 TENNYSON ST
Mailing Address - Street 2:UNIT 111
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2107
Mailing Address - Country:US
Mailing Address - Phone:303-495-6991
Mailing Address - Fax:
Practice Address - Street 1:825 E SPEER BLVD STE 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218
Practice Address - Country:US
Practice Address - Phone:303-495-6991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1038106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty