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General NPI Number Information
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NPI Number | 1730075284
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Entity Type | Organization
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Legal Business Name | UNBOUND WELLNESS PLLC
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 1100 WAKE FOREST RD STE 100-E
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City | RALEIGH
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State | NC
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Zip | 27604-1354
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Country | US
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Telephone | 919-561-5086
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Fax |
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Provider Business Mailing Address
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Address Line | 8107 AMADOR WAY
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City | RALEIGH
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State | NC
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Zip | 27616-5995
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Country | US
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Telephone | 919-791-7674
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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 | EMMA BLAISE VAN HORNE
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Credential | LCSWA
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Telephone | 919-561-5086
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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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