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General NPI Number Information
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NPI Number | 1679329155
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Entity Type | Organization
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Legal Business Name | LOTUS RENEWAL AND WELLNESS CENTER, INC
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 07/13/2025
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Provider Practice Location Address
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Address Line | 945 WARNER RD
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City | URBANNA
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State | VA
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Zip | 23175-2593
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Country | US
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Telephone | 804-577-0072
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Fax | 804-895-7865
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Provider Business Mailing Address
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Address Line | 945 WARNER RD
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City | URBANNA
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State | VA
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Zip | 23175-2593
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Country | US
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Telephone | 804-577-0072
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Fax | 804-895-7865
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Authorized Official
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Title or Position | FOUNDER
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Name | MRS. PAMELA MINOR
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Credential | LPC
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Telephone | 804-220-6321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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