Provider Demographics
NPI:1780410001
Name:HEALING PATH HOLISTIC PSYCHIATRY
Entity type:Organization
Organization Name:HEALING PATH HOLISTIC PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRETON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, PMHNP-BC
Authorized Official - Phone:207-204-3671
Mailing Address - Street 1:13 RAILROAD SQ STE 1
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6139
Mailing Address - Country:US
Mailing Address - Phone:207-204-3671
Mailing Address - Fax:207-607-7816
Practice Address - Street 1:13 RAILROAD SQ STE 1
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6139
Practice Address - Country:US
Practice Address - Phone:207-204-3671
Practice Address - Fax:207-607-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty