Provider Demographics
NPI:1881956852
Name:DRAMA FOR HEALING, LLC
Entity type:Organization
Organization Name:DRAMA FOR HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MIZUHO
Authorized Official - Middle Name:
Authorized Official - Last Name:KANAZAWA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCAT, RDT
Authorized Official - Phone:201-298-3131
Mailing Address - Street 1:127 CHRISTIE STREET
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605
Mailing Address - Country:US
Mailing Address - Phone:201-298-3131
Mailing Address - Fax:
Practice Address - Street 1:127 CHRISTIE STREET
Practice Address - Street 2:1ST FLOOR
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605
Practice Address - Country:US
Practice Address - Phone:201-298-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000266-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health