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General NPI Number Information
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NPI Number | 1376417477
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Entity Type | Organization
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Legal Business Name | A RADIANCE WELLNESS, LLC
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 9636 PIPER LAKE DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-6830
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Country | US
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Telephone | 317-640-5072
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Fax | 317-640-5072
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Provider Business Mailing Address
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Address Line | 9636 PIPER LAKE DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-6830
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Country | US
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Telephone | 317-640-5072
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Fax | 317-640-5072
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Authorized Official
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Title or Position | CEO/OWNER
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Name | SHALEEA MASON
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Credential | NP
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Telephone | 317-640-5072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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