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General NPI Number Information
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NPI Number | 1720701337
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Entity Type | Organization
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Legal Business Name | ZENWAR WELLNESS INC
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 157 MAHOGANY BAY DR
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City | SAINT JOHNS
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State | FL
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Zip | 32259-6949
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Country | US
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Telephone | 904-657-1533
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Fax | 833-799-3395
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Provider Business Mailing Address
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Address Line | 157 MAHOGANY BAY DR
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City | SAINT JOHNS
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State | FL
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Zip | 32259-6949
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Country | US
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Telephone | 904-657-1533
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED CLINICAL SOCIAL WORK
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Name | RENEE GARCIA WYDEN
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Credential | EDD,LCSW
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Telephone | 904-657-1533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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