Organization Name: | INTEGRAL WELLNESS, LLC |
NPI Number: | 1538324231 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KARY ANN BENNETT (LICENSED MENTAL HEALTH COUNSELOR) |
Mailing Address: | 234 Maple St Stowe |
State: | VT US |
Postal Code: | 056724248 |
Phone Number: | 8022537337 |
Fax Number: | 8022537332 |
NPI Enumeration Date: | 07/22/2008 |
NPI Last Update Date: | 07/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 068-0000751 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |