| Organization Name: | A BEAUTIFUL JOURNEY, LLC |
| NPI Number: | 1003221789 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACQUELINE ANDERSON (OWNER/PROFESSIONAL COUNSELOR) |
| Mailing Address: | 5601 W Grande Market Dr Suite H Appleton |
| State: | WI US |
| Postal Code: | 549138511 |
| Phone Number: | 9202683242 |
| Fax Number: | |
| NPI Enumeration Date: | 06/21/2014 |
| NPI Last Update Date: | 10/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 4691125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |