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General NPI Number Information
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NPI Number | 1093072936
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Entity Type | Organization
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Legal Business Name | ART OF WELLNESS
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Dates
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Enumeration Date | 04/17/2012
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Last Update Date | 07/24/2014
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Provider Practice Location Address
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Address Line | 1930 S BROAD ST UNIT 16
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City | PHILADELPHIA
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State | PA
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Zip | 19145-2328
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Country | US
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Telephone | 267-242-6284
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Fax | 215-701-4992
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Provider Business Mailing Address
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Address Line | 1930 S BROAD ST UNIT 16
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City | PHILADELPHIA
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State | PA
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Zip | 19145-2328
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Country | US
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Telephone | 267-242-6284
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Fax | 215-701-4992
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. YAN Q. HUO
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Credential | LPC
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Telephone | 267-242-6284
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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 | PC004265
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License Number State | PA
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