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General NPI Number Information
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NPI Number | 1205480993
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Entity Type | Organization
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Legal Business Name | WHOLE PERSON WELLNESS, INC.
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 13180 N CLEVELAND AVE STE 214
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-6231
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Country | US
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Telephone | 239-826-8347
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Fax |
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Provider Business Mailing Address
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Address Line | 501 SE 17TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33990-2224
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Country | US
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Telephone | 239-826-8347
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONNA SAN SALVADOR
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Credential | LMHC, NCC
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Telephone | 239-826-8347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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