Organization Name: | THE WELLNESS CONNECTION |
NPI Number: | 1487906467 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN MCCORMICK (OWNER) |
Mailing Address: | 24600 Millstream Dr Stone Ridge |
State: | VA US |
Postal Code: | 201055685 |
Phone Number: | 7033270335 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2012 |
NPI Last Update Date: | 10/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |