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General NPI Number Information
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NPI Number | 1316769185
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Entity Type | Organization
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Legal Business Name | CALM - BRAIN & BODY WELLNESS
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Dates
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Enumeration Date | 10/31/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 777 W RED MARBLE LN
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City | SAINT GEORGE
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State | UT
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Zip | 84790-1946
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Country | US
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Telephone | 435-862-8129
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Fax |
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Provider Business Mailing Address
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Address Line | 777 W RED MARBLE LN
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City | SAINT GEORGE
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State | UT
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Zip | 84790-1946
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Country | US
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Telephone | 435-862-8129
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LUCAS HAWS
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Credential |
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Telephone | 435-862-8129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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