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General NPI Number Information
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NPI Number | 1104567072
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Entity Type | Organization
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Legal Business Name | WELLNESS GROWTH & HEALING, LLC
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 10404 ARTEMIS CT
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City | SPRING VALLEY
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State | CA
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Zip | 91977-7143
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Country | US
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Telephone | 773-562-7943
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Fax |
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Provider Business Mailing Address
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Address Line | 10404 ARTEMIS CT
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City | SPRING VALLEY
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State | CA
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Zip | 91977-7143
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MONIQUE LITTLE
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Credential |
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Telephone | 773-562-7943
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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 |
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License Number State |
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