Healthcare Provider Details

I. General information

NPI: 1073998928
Provider Name (Legal Business Name): EMOWELLNESS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 07/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1058 W CLUB BLVD SUITE 614
DURHAM NC
27701-1104
US

IV. Provider business mailing address

1058 W CLUB BLVD SUITE 614
DURHAM NC
27701-1104
US

V. Phone/Fax

Practice location:
  • Phone: 919-416-3737
  • Fax:
Mailing address:
  • Phone: 919-416-3737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number069765
License Number StateNC

VIII. Authorized Official

Name: DR. MARCELLA ATWATER
Title or Position: OWNER
Credential: PSYC CNS ADULT
Phone: 919-416-3737