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General NPI Number Information
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NPI Number | 1790698066
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Entity Type | Organization
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Legal Business Name | INNER SOL WELLNESS CO., LLC
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 16948 PARK PLACE ST APT 4
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City | EAGLE RIVER
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State | AK
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Zip | 99577-7883
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Country | US
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Telephone | 208-270-4257
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Fax |
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Provider Business Mailing Address
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Address Line | 16948 PARK PLACE ST APT 4
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City | EAGLE RIVER
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State | AK
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Zip | 99577-7883
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Country | US
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Telephone | 208-270-4257
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | CARLIE JARAMILLO
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Credential | LCSW
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Telephone | 208-270-4257
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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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