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General NPI Number Information
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NPI Number | 1447996590
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Entity Type | Organization
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Legal Business Name | NEPHESH WELLNESS LLC
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 700 N. BRUCE LN. UNIT 307
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City | GLENWOOD
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State | IL
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Zip | 60425
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Country | US
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Telephone | 312-259-3166
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Fax |
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Provider Business Mailing Address
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Address Line | 18300 S HALSTED ST STE B
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City | GLENWOOD
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State | IL
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Zip | 60425-1051
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Country | US
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Telephone | 708-252-3185
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KIMBERLY S NELSON-ARRINGTON
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Credential | PSYD, PHD
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Telephone | 708-252-3185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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