Healthcare Provider Details

I. General information

NPI: 1750057477
Provider Name (Legal Business Name): POISED ONDEMAND-PROMOTING OPULENCE IN SOCIAL EMOTIONAL DEVELOPMENT LIM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2021
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

649 BRONX RIVER ROAD 3R
YONKERS NY
10704
US

IV. Provider business mailing address

649 BRONX RIVER ROAD 3R
YONKERS NY
10704
US

V. Phone/Fax

Practice location:
  • Phone: 914-885-5093
  • Fax:
Mailing address:
  • Phone: 914-885-5093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: MISS RAQUEL JOHNSON
Title or Position: CHIEF EXECUTIVE DIRECTOR
Credential: B.S PSYCHOLOGY
Phone: 914-885-5093