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General NPI Number Information
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NPI Number | 1720689888
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Entity Type | Organization
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Legal Business Name | BALANCE TO HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 5135 MORGANTON RD STE 201
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-1525
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Country | US
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Telephone | 910-922-0441
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1267
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City | RAEFORD
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State | NC
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Zip | 28376-1267
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Country | US
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Telephone | 910-922-0441
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. QUANDA LASHAWN BANKS-MONTANEZ
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Credential | LCMHC
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Telephone | 910-922-0441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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