Organization
LIVE, BREATHE & PLAY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE KAY BURKHARDT LMHC, NCC, RPT-S (OWNER)
(260) 519-1234
Entity
Organization
Contact information
Practice address
954 EASTPORT CENTRE DR STE B, VALPARAISO, IN 46383-4456
(219) 286-6482
(219) 286-7367
Mailing address
954 EASTPORT CENTRE DR STE B, VALPARAISO, IN 46383-4456
(219) 286-6482
(219) 286-7367
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001475A
IN
Other
Enumeration date
09/14/2017
Last updated
07/21/2022
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