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General NPI Number Information
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NPI Number | 1346860038
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Entity Type | Organization
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Legal Business Name | WELLNESS MIND CENTER LLC
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 1413 K ST NW FL 4
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City | WASHINGTON
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State | DC
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Zip | 20005-4577
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Country | US
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Telephone | 202-430-6249
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Fax |
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Provider Business Mailing Address
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Address Line | 900 ARMY NAVY DR APT 1203
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City | ARLINGTON
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State | VA
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Zip | 22202-4928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. JUAN ROSAS
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Credential |
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Telephone | 681-443-5138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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