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General NPI Number Information
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NPI Number | 1831804400
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Entity Type | Organization
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Legal Business Name | HELLO WONDERWORK INC.
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 235 IRONWORKS AVE UNIT #473
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City | MISHAWAKA
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State | IN
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Zip | 46544
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Country | US
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Telephone | 415-915-6556
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Fax |
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Provider Business Mailing Address
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Address Line | 5214F DIAMOND HEIGHTS BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-2175
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Country | US
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Telephone | 415-915-6556
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Fax |
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Authorized Official
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Title or Position | COO
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Name | KALKIN SHELAT
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Credential |
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Telephone | 574-402-8736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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