Healthcare Provider Details

I. General information

NPI: 1639847478
Provider Name (Legal Business Name): THERAPEUTIC WELLNESS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2021
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 YORKLYN RD STE 400
HOCKESSIN DE
19707-8740
US

IV. Provider business mailing address

722 YORKLYN RD STE 400
HOCKESSIN DE
19707-8740
US

V. Phone/Fax

Practice location:
  • Phone: 302-235-3398
  • Fax: 302-543-2029
Mailing address:
  • Phone: 302-235-3398
  • Fax: 302-543-2029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL M JANNEY
Title or Position: MANAGER
Credential: PHD
Phone: 302-235-3398