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General NPI Number Information
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NPI Number | 1780338467
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Entity Type | Organization
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Legal Business Name | ELITE WELLNESS SOLUTIONS, LLC
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 3401 NORMAN BERRY DR STE 111
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City | EAST POINT
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State | GA
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Zip | 30344-5102
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Country | US
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Telephone | 404-225-2794
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 NORMAN BERRY DR STE 111
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City | EAST POINT
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State | GA
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Zip | 30344-5102
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Country | US
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Telephone | 404-225-2794
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | SHALONDA D. PETTIS
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Credential | MMSC, PA, CHC
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Telephone | 770-317-5743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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