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General NPI Number Information
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NPI Number | 1780256164
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Entity Type | Organization
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Legal Business Name | MAXEMA & ESTELLE WELLNESS SOLUTIONS, LLC
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 1540 CENTER POINT PKWY STE 202
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City | CENTER POINT
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State | AL
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Zip | 35215-5666
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Country | US
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Telephone | 205-718-1503
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 CENTER POINT PKWY STE 202
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City | CENTER POINT
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State | AL
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Zip | 35215-5666
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Country | US
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Telephone | 205-718-1503
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | KENDRALIA AGAZIE
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Credential | RN, LGSW
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Telephone | 205-718-1503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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