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General NPI Number Information
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NPI Number | 1003417262
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Entity Type | Organization
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Legal Business Name | WELLNESS WITHIN HOLISTIC PSYCHOTHERAPY, PA
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 3960 SAARI RD
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City | HIBBING
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State | MN
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Zip | 55746-8280
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Country | US
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Telephone | 562-882-6511
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Fax |
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Provider Business Mailing Address
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Address Line | 3960 SAARI RD
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City | HIBBING
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State | MN
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Zip | 55746-8280
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Country | US
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Telephone | 562-882-6511
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. FRANCY LYNN JENKO
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Credential | DSW, MSW, LICSW
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Telephone | 562-882-6511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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