Healthcare Provider Details

I. General information

NPI: 1326810078
Provider Name (Legal Business Name): WHOLEPATH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E NAYLOR MILL RD UNIT F
SALISBURY MD
21804-2256
US

IV. Provider business mailing address

720 WALLASEY DR
MIDDLETOWN DE
19709-1547
US

V. Phone/Fax

Practice location:
  • Phone: 302-602-6850
  • Fax:
Mailing address:
  • Phone: 302-602-6850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HILDA AZEFOR
Title or Position: PRESIDENT
Credential: PMHNP
Phone: 302-602-6850