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General NPI Number Information
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NPI Number | 1679808141
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Entity Type | Organization
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Legal Business Name | PATH TO WELLNESS, INC.
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Dates
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Enumeration Date | 10/16/2009
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Last Update Date | 10/16/2009
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Provider Practice Location Address
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Address Line | 334 OLD CHAPIN RD
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City | LEXINGTON
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State | SC
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Zip | 29072-8801
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Country | US
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Telephone | 803-260-1171
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Fax | 803-359-7869
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Provider Business Mailing Address
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Address Line | 334 OLD CHAPIN RD
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City | LEXINGTON
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State | SC
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Zip | 29072-8801
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Country | US
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Telephone | 803-260-1171
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Fax | 803-359-7869
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | DR. MARI E. BLOING-HART
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Credential | PH.D.
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Telephone | 803-260-1171
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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 | 6070
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License Number State | SC
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