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General NPI Number Information
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NPI Number | 1831826817
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Entity Type | Organization
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Legal Business Name | MAKE ME OVER WHOLISTIC HEALTH AND STRESS MANAGEMENT CENT LLC
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 10979 REED HARTMAN HWY STE 100
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City | BLUE ASH
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State | OH
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Zip | 45242-2857
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Country | US
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Telephone | 513-888-3198
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Fax |
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Provider Business Mailing Address
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Address Line | 10979 REED HARTMAN HWY STE 100
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City | BLUE ASH
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State | OH
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Zip | 45242-2857
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Country | US
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Telephone | 513-888-3198
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Fax |
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Authorized Official
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Title or Position | AO
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Name | PAMELA JEAN JENKINS
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Credential | MSW, LSW, LMT
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Telephone | 513-888-3198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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