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General NPI Number Information
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NPI Number | 1730952037
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE HOLISTIC WELLNESS
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 653 SKIPPACK PIKE STE 300-35
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City | BLUE BELL
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State | PA
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Zip | 19422-1742
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Country | US
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Telephone | 215-948-9454
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 LIMEKILN PIKE STE B19
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City | DRESHER
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State | PA
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Zip | 19025-1503
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Country | US
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Telephone | 215-948-9454
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DISHEENA M THOMAS
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Credential | LPC
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Telephone | 267-252-8102
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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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