| Organization Name: | TLC WHOLENESS CENTER |
| NPI Number: | 1851610125 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANN MARIE RUTH DEVIZIA (DIRECTOR LICENSED PROFESSIONAL COUN) |
| Mailing Address: | 426 Pennsylvania Ave Ste 101 Ft Washington |
| State: | PA US |
| Postal Code: | 190343410 |
| Phone Number: | 2156207660 |
| Fax Number: | 2157730789 |
| NPI Enumeration Date: | 05/25/2010 |
| NPI Last Update Date: | 05/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | PC002951 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |