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General NPI Number Information
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NPI Number | 1194401034
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Entity Type | Organization
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Legal Business Name | WOMEN'S WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 1918 BENTLEY ST
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City | HOPKINSVILLE
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State | KY
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Zip | 42240
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Country | US
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Telephone | 270-348-6167
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Fax |
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Provider Business Mailing Address
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Address Line | 1918 BENTLEY ST
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City | HOPKINSVILLE
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State | KY
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Zip | 42240
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Country | US
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Telephone | 270-348-6167
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHERRI BONCHELE GREEN
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Credential | LPC-A
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Telephone | 270-348-6167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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