Healthcare Provider Details

I. General information

NPI: 1255116828
Provider Name (Legal Business Name): HARMONIA WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3653 CORTEZ RD W STE 110D
BRADENTON FL
34210-3168
US

IV. Provider business mailing address

5838 CALLA LILLY DR
SARASOTA FL
34232-2337
US

V. Phone/Fax

Practice location:
  • Phone: 941-347-0255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KERI WANNER
Title or Position: OWNER/THERAPIST
Credential: LMHC
Phone: 908-251-7533