=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346189735
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WICK AND BURN CANDLE BAR LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2026
-----------------------------------------------------
Last Update Date | 03/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 805 N MAIN ST
-----------------------------------------------------
City | SALADO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76571-5864
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-282-6539
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5219 BIRMINGHAM CIR
-----------------------------------------------------
City | KILLEEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76542-5460
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-282-6539
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | DENISE WASHINGTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 254-251-0457
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------