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General NPI Number Information
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NPI Number | 1326934795
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Entity Type | Organization
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Legal Business Name | HOLISTIC HAVEN THERAPY LLC
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 9460 S ORANGE BLOSSOM TRL
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City | ORLANDO
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State | FL
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Zip | 32837
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Country | US
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Telephone | 863-657-5691
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Fax | 518-977-7100
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Provider Business Mailing Address
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Address Line | 9460 S ORANGE BLOSSOM TRL
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City | ORLANDO
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State | FL
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Zip | 32837
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Country | US
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Telephone | 863-657-5691
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Fax | 518-977-7100
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Authorized Official
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Title or Position | MANAGER
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Name | SADIA ANJUM MOHAMMADI
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Credential | REVEREND DR, MA, HP
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Telephone | 863-657-5691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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