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General NPI Number Information
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NPI Number | 1669213765
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Entity Type | Organization
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Legal Business Name | QUANTUM HEALING WORKS, INC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 440 E MAIN ST
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City | WYTHEVILLE
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State | VA
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Zip | 24382-2328
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Country | US
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Telephone | 757-306-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 440 E MAIN ST
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City | WYTHEVILLE
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State | VA
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Zip | 24382-2328
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Country | US
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Telephone | 757-306-9100
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUZAN K THOMPSON
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Credential | PH.D., LPC
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Telephone | 757-306-9100
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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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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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