Provider Demographics
NPI:1194364299
Name:BUSHENHEALING AND LIFE ARTS, LLC
Entity type:Organization
Organization Name:BUSHENHEALING AND LIFE ARTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPS, LAC
Authorized Official - Phone:917-971-4110
Mailing Address - Street 1:30 WINDING LANE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507
Mailing Address - Country:US
Mailing Address - Phone:917-971-4110
Mailing Address - Fax:
Practice Address - Street 1:30 WINDING LANE
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507
Practice Address - Country:US
Practice Address - Phone:917-971-4110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty