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General NPI Number Information
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NPI Number | 1851999650
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Entity Type | Organization
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Legal Business Name | PALM WELLNESS, LLC
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 11/19/2023
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Provider Practice Location Address
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Address Line | 565 W BAGLEY RD
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City | BEREA
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State | OH
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Zip | 44017-1328
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Country | US
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Telephone | 440-212-1389
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Fax |
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Provider Business Mailing Address
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Address Line | 565 W BAGLEY RD
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City | BEREA
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State | OH
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Zip | 44017-1328
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Country | US
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Telephone | 440-212-1389
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL CLINICAL COUNSELOR
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Name | PHILLIP PALMISON
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Credential |
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Telephone | 440-212-1389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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