Provider Demographics
NPI:1750080503
Name:REZILIENT HEALING, LLC
Entity type:Organization
Organization Name:REZILIENT HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DURINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYONNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-453-6489
Mailing Address - Street 1:1900 W CARLA VISTA DR UNIT 7633
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-4067
Mailing Address - Country:US
Mailing Address - Phone:480-453-6489
Mailing Address - Fax:
Practice Address - Street 1:2022 N NEVADA ST APT 1038
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0957
Practice Address - Country:US
Practice Address - Phone:480-453-6489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty