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General NPI Number Information
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NPI Number | 1225624299
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Entity Type | Organization
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Legal Business Name | HOLISTIC PSYCHOTHERAPY & RESEARCH
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Dates
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Enumeration Date | 12/14/2020
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 3900 CITY AVE APT A722
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City | PHILADELPHIA
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State | PA
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Zip | 19131-2974
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Country | US
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Telephone | 954-787-8060
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 CITY AVE APT A722
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City | PHILADELPHIA
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State | PA
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Zip | 19131-2974
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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 | OWNER
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Name | DENISE RODRIGUEZ BROWN
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Credential |
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Telephone | 954-787-8060
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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 Agency
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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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