Healthcare Provider Details

I. General information

NPI: 1750151668
Provider Name (Legal Business Name): TOHWIKELI TRAUMA SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 HAWK RIDGE ST
ROUND ROCK TX
78665-1130
US

IV. Provider business mailing address

PO BOX 116
MC NEIL TX
78651-0116
US

V. Phone/Fax

Practice location:
  • Phone: 737-304-6892
  • Fax:
Mailing address:
  • Phone: 737-304-6892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ELLEN PAYNE
Title or Position: OWNER & THERAPIST
Credential: LCSW
Phone: 737-304-6892