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General NPI Number Information
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NPI Number | 1114791969
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Entity Type | Organization
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Legal Business Name | ENLIGHTENED WELLNESS SOLUTIONS LLC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 155 WILLOWBROOK BLVD STE 110
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City | WAYNE
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State | NJ
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Zip | 07470-7033
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Country | US
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Telephone | 848-229-1424
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Fax |
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Provider Business Mailing Address
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Address Line | 155 WILLOWBROOK BLVD STE 110
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City | WAYNE
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State | NJ
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Zip | 07470-7033
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Country | US
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Telephone | 862-224-4863
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Fax |
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Authorized Official
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Title or Position | OWNER OF THE BUSINESS
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Name | MRS. TOMEKA MAPP
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Credential | APRN, MSN. PMHNP-BC
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Telephone | 848-229-1424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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