| Experiential Healing Pllc | |
|
188 Lodge Rd Freeport FL 32439-2212 | |
| (850) 333-6283 | |
| Not Available |
| Full Name | Experiential Healing Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 188 Lodge Rd, Freeport, Florida |
| Authorized Official Name and Position | Shannon Brunson (OWNER/CEO) |
| Authorized Official Contact | 8509782852 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Experiential Healing Pllc 188 Lodge Rd Freeport FL 32439-2212 Ph: (850) 978-2852 | Experiential Healing Pllc 188 Lodge Rd Freeport FL 32439-2212 Ph: (850) 333-6283 |
| NPI Number | 1538961164 |
|---|---|
| Provider Enumeration Date | 03/25/2025 |
| Last Update Date | 03/30/2025 |
| Certification Date | 03/30/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538961164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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