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General NPI Number Information
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NPI Number | 1598185860
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Entity Type | Organization
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Legal Business Name | INSTITUTE OF WHOLISTIC EMPOWERMENT
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 1065 NE 125 STREET, SUITE 317A
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City | NORTH MIAMI
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State | FL
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Zip | 33161
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Country | US
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Telephone | 786-489-5429
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 551874
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City | MIAMI GARDENS
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State | FL
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Zip | 33056
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Country | US
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Telephone | 786-489-5429
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MAIRLYN LIGHTBOUM-OSHODI
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Credential |
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Telephone | 786-489-5429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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