Provider Demographics
NPI:1356108476
Name:MEDICAL HYPNOSIS CENTER INC
Entity type:Organization
Organization Name:MEDICAL HYPNOSIS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SQUICQUERO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-674-0191
Mailing Address - Street 1:725 BOARDMAN CANFIELD RD STE O
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4359
Mailing Address - Country:US
Mailing Address - Phone:330-758-4515
Mailing Address - Fax:330-758-2862
Practice Address - Street 1:1180 MAIN ST UNIT B
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4753
Practice Address - Country:US
Practice Address - Phone:970-674-0191
Practice Address - Fax:970-674-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty