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General NPI Number Information
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NPI Number | 1255941472
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Entity Type | Organization
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Legal Business Name | HOLISTIC BEHAVIORAL SOLUTIONS
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 65 S MAIN ST STE C001
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City | PENNINGTON
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State | NJ
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Zip | 08534-2822
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Country | US
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Telephone | 609-752-3098
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Fax | 866-268-8014
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | PENNINGTON
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State | NJ
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Zip | 08534-0497
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Country | US
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Telephone | 609-752-3098
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | TAMARA POMMELLS
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Credential |
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Telephone | 609-468-1690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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