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General NPI Number Information
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NPI Number | 1093050890
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Entity Type | Organization
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Legal Business Name | THE PERSONAL WELLNESS CENTER
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 6508 DEER POINTE DR STE 4C
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City | SALISBURY
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State | MD
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Zip | 21804-1668
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Country | US
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Telephone | 410-742-6016
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Fax | 410-742-6014
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Provider Business Mailing Address
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Address Line | 6508 DEER POINTE DR STE 4C
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City | SALISBURY
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State | MD
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Zip | 21804-1668
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Country | US
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Telephone | 410-742-6016
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Fax | 410-742-6014
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/OWNER
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Name | VERONICA CORREA
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Credential | LCSW-C
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Telephone | 410-742-6016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11098
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License Number State | MD
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