Provider Demographics
NPI:1992337778
Name:TRANSFORM YOUR BIRTH, LLC
Entity type:Organization
Organization Name:TRANSFORM YOUR BIRTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BODILY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:636-699-2839
Mailing Address - Street 1:677 CRAIG RD STE 208
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7125
Mailing Address - Country:US
Mailing Address - Phone:636-699-2839
Mailing Address - Fax:844-641-1015
Practice Address - Street 1:677 CRAIG RD STE 208
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7125
Practice Address - Country:US
Practice Address - Phone:636-699-2839
Practice Address - Fax:844-641-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty