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General NPI Number Information
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NPI Number | 1255106100
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Entity Type | Organization
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Legal Business Name | NURTURED PELVIC HEALTH & WELLNESS
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 44 PAWNEE AVE
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-3010
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Country | US
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Telephone | 201-213-5202
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Fax |
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Provider Business Mailing Address
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Address Line | 44 PAWNEE AVE
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-3010
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Country | US
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Telephone | 201-213-5202
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Fax |
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Authorized Official
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Title or Position | OWNER/ OCCUPATIONAL THERAPIST
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Name | MRS. RACHEL LEE KELLY
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Credential | OTR
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Telephone | 201-213-5202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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