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General NPI Number Information
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NPI Number | 1144692419
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Entity Type | Organization
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Legal Business Name | MILLENIA HEALTH AND WELLNESS
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 4068 HOLLY VILLA CIR
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-3726
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Country | US
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Telephone | 704-615-7544
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Fax |
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Provider Business Mailing Address
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Address Line | 4068 HOLLY VILLA CIR
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-3726
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Country | US
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Telephone | 704-615-7544
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH PROFESSIONAL
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Name | ERICA N MCNEIL
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Credential | MASTERS LEVEL
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Telephone | 704-615-7544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health
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License Number |
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License Number State |
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