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General NPI Number Information
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NPI Number | 1487355871
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Entity Type | Organization
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Legal Business Name | OMNIA TRAUMA HEALING LLC
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Dates
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Enumeration Date | 03/14/2023
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1415 PARTIN DR N
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City | NICEVILLE
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State | FL
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Zip | 32578-1460
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Country | US
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Telephone | 850-460-7771
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Fax |
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Provider Business Mailing Address
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Address Line | 1603A PARTIN DR N
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City | NICEVILLE
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State | FL
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Zip | 32578-1440
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Country | US
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Telephone | 850-460-7771
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Fax | 850-660-7771
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Authorized Official
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Title or Position | FOUNDER/DIRECTOR
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Name | DR. ALYSSA MARIE GAVULIC HOWK
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Credential | PHD, LMHC-S, LMFT-S
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Telephone | 850-460-7771
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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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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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