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Organization
EARTHEART LLC
Active
Organization
EARTHEART LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRET EARTHEART LCSW (TIN OWNER)
(812) 345-2176
Entity
Organization
Contact information
Practice address
4307 S LEONARD SPRINGS RD, BLOOMINGTON, IN 47403-4078
(812) 345-2176
(206) 984-2440
Mailing address
4307 S LEONARD SPRINGS RD, BLOOMINGTON, IN 47403-4078
(812) 345-2176
(206) 984-2440
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/06/2016
Last updated
11/29/2018
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