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General NPI Number Information
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NPI Number | 1538775200
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Entity Type | Organization
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Legal Business Name | WELLNESS JOURNEY, LLC
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 3600 HEMLOCK AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-1328
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Country | US
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Telephone | 804-931-1182
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Fax | 804-655-6170
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Provider Business Mailing Address
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Address Line | 14525 WOODLEIGH DR
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City | CHESTER
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State | VA
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Zip | 23831-6587
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Country | US
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Telephone | 804-931-1182
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Fax | 804-655-6170
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CYNTHIA L MINTO
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Credential | PHD, LCP
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Telephone | 804-931-1182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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