Provider Demographics
NPI:1356594055
Name:HORSES HEALING HEARTS, PLLC
Entity type:Organization
Organization Name:HORSES HEALING HEARTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:O'CONNELL BAGNATI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-817-6075
Mailing Address - Street 1:6411 WET MARSH CT
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2927
Mailing Address - Country:US
Mailing Address - Phone:757-817-6075
Mailing Address - Fax:866-757-5778
Practice Address - Street 1:6100 CRITTENDEN RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23432-1204
Practice Address - Country:US
Practice Address - Phone:757-817-6075
Practice Address - Fax:866-757-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty