Healthcare Provider Details

I. General information

NPI: 1063338739
Provider Name (Legal Business Name): INNERBALANCE WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1210 SE MAYNARD RD
CARY NC
27511-6943
US

IV. Provider business mailing address

501 W WILLIAMS ST UNIT 1036
APEX NC
27502-2297
US

V. Phone/Fax

Practice location:
  • Phone: 919-576-2607
  • Fax: 919-935-0858
Mailing address:
  • Phone: 919-576-2607
  • Fax: 919-935-0858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHIRLEYJO B LEE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 919-576-2607