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General NPI Number Information
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NPI Number | 1033934948
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Entity Type | Organization
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Legal Business Name | ELEVENS WELLNESS LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1412 ALTOONA AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4279
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Country | US
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Telephone | 715-210-9284
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Fax | 715-972-4422
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Provider Business Mailing Address
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Address Line | 1412 ALTOONA AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4279
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Country | US
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Telephone |
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Fax | 715-972-4422
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Authorized Official
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Title or Position | OWNER
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Name | BRITA SPENCER
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Credential | LICSW
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Telephone | 844-482-7296
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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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