# INTENTIONAL HEALING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215785787
- **Authorized official:** LAURA PORTER NP (CEO)
- **Authorized official phone:** (480) 815-7311

## Contact information

- **Practice address:** 1166 E WARNER RD STE 113, GILBERT, AZ 85296-3065
- **Practice address phone:** (480) 815-7311
- **Mailing address:** 7908 E PERALTA AVE, MESA, AZ 85212-1561
- **Mailing address phone:** (480) 282-0197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/09/2024
- **Last updated:** 01/28/2025