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General NPI Number Information
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NPI Number | 1902353766
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Entity Type | Organization
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Legal Business Name | HEART 2 HEART WELLNESS, LLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 1919 STATE ST SUITE 18
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City | NEW ALBANY
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State | IN
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Zip | 47150-4929
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Country | US
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Telephone | 502-608-0850
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 STATE ST SUITE 18
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City | NEW ALBANY
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State | IN
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Zip | 47150-4929
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Country | US
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Telephone | 502-608-0850
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GLYNITA RICE
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Credential | LCSW
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Telephone | 502-608-0850
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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 | 3837
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34006576A
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License Number State | IN
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