Provider Demographics
NPI:1447830385
Name:DREAM LIFE OUT LOUD, PLLC
Entity type:Organization
Organization Name:DREAM LIFE OUT LOUD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFTA
Authorized Official - Phone:206-338-6688
Mailing Address - Street 1:8217 S 120TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-4434
Mailing Address - Country:US
Mailing Address - Phone:206-338-6688
Mailing Address - Fax:
Practice Address - Street 1:8217 S 120TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-4434
Practice Address - Country:US
Practice Address - Phone:206-338-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health