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General NPI Number Information
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NPI Number | 1063006484
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Entity Type | Organization
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Legal Business Name | HEALING TREE MENTAL WELLNESS, LLC
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 400 N ORANGE ST
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City | WILMINGTON
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State | DE
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Zip | 19801-2219
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Country | US
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Telephone | 302-670-5347
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Fax |
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Provider Business Mailing Address
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Address Line | 355 RYAN RD
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City | SMYRNA
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State | DE
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Zip | 19977-3698
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Country | US
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Telephone | 302-670-5347
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MS. KIMBERLY G. MURTHA
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Credential | LPCMH
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Telephone | 302-670-5347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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