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NPI Code Detail

MEDICARE: INTEGRATIVE WELLNESS THERAPY

MEDICARE: INTEGRATIVE WELLNESS THERAPY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1902740699
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATIVE WELLNESS THERAPY
Provider Business Mailing Address
First Line : 20283 LAGENTE CIR
Second Line :
City : VENICE
State : FL
Zip : 34293-2861
Country : US
Telephone Number : 678-294-9173
Fax Number :
Provider Business Practice Location Address
First Line : 1600 CENTER RD
Second Line :
City : VENICE
State : FL
Zip : 34292-3841
Country : US
Telephone Number : 941-297-3570
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST / OWNER
Name : NICOLE DAHLENBURG
Credential : OTR/L
Telephone Number : 678-294-9173
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

Similar Medicare Providers

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Practice Location Address:
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1518277656 — MS. CYNTHIA DE LEON FUENTES
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Directions to “INTEGRATIVE WELLNESS THERAPY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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