# NWI OROFACIAL MYOFUNCTIONAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1790454817
- **Authorized official:** MRS. STACY LASHENIK LDH (MYOFUNCTIONAL THERAPIST)
- **Authorized official phone:** (219) 661-7271

## Contact information

- **Practice address:** 566 N INDIANA AVE, CROWN POINT, IN 46307-3412
- **Practice address phone:** (219) 661-7271
- **Mailing address:** PO BOX 2425, VALPARAISO, IN 46384-2425
- **Mailing address phone:** (219) 661-7271

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171400000X | Health & Wellness Coach | — | NULL | Yes |
| 171400000X | Health & Wellness Coach | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2021
- **Last updated:** 09/10/2021