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General NPI Number Information
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NPI Number | 1386455400
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Entity Type | Organization
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Legal Business Name | WELLNESS WAVE INC.
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 8326 S CORAL CIRCLE
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068
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Country | US
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Telephone | 954-770-7546
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 NW 72ND AVE STE 455
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City | MIAMI
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State | FL
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Zip | 33126-1947
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Country | US
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Telephone | 954-770-7546
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Fax |
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Authorized Official
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Title or Position | CO
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Name | TENNILE NEMBHARD
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Credential |
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Telephone | 954-266-8362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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