Healthcare Provider Details

I. General information

NPI: 1548125958
Provider Name (Legal Business Name): WHOLISTIC SOUL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2076 MESA DR SE
ATLANTA GA
30316-4916
US

IV. Provider business mailing address

1605 CHURCH ST STE 610-200
DECATUR GA
30033-6065
US

V. Phone/Fax

Practice location:
  • Phone: 562-239-7006
  • Fax:
Mailing address:
  • Phone: 562-239-7006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY FELIX
Title or Position: FOUNDER/PRESIDENT
Credential:
Phone: 562-239-7006