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General NPI Number Information
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NPI Number | 1871304113
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Entity Type | Organization
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Legal Business Name | GUIDED WELLNESS THERAPY LLC
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 101 MACARTHUR RD
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City | STONEHAM
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State | MA
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Zip | 02180-3411
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Country | US
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Telephone | 781-640-4345
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Fax |
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Provider Business Mailing Address
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Address Line | 101 MACARTHUR RD
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City | STONEHAM
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State | MA
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Zip | 02180-3411
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JOHN PATRICK TRAVIS
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Credential | M.ED, LMHC
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Telephone | 781-640-4345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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