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General NPI Number Information
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NPI Number | 1033875190
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Entity Type | Organization
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Legal Business Name | WHOLE MIND, LLC
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Dates
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Enumeration Date | 11/12/2021
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1379 E END RD STE 3
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City | HOMER
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State | AK
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Zip | 99603-7250
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Country | US
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Telephone | 907-299-6410
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 401
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City | HOMER
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State | AK
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Zip | 99603-0401
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Country | US
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Telephone | 907-299-6410
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRANDY ZOLLARS
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Credential | PMHNP-BC
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Telephone | 267-733-2695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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