Provider Demographics
NPI:1992574578
Name:OMNIHEALING THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:OMNIHEALING THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:763-732-2320
Mailing Address - Street 1:5901 BROOKLYN BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-2533
Mailing Address - Country:US
Mailing Address - Phone:651-337-9047
Mailing Address - Fax:763-657-1689
Practice Address - Street 1:5901 BROOKLYN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-2533
Practice Address - Country:US
Practice Address - Phone:651-337-9047
Practice Address - Fax:763-657-1689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-25
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty