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General NPI Number Information
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NPI Number | 1912272873
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Entity Type | Organization
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Legal Business Name | WHOLENESS HEALING CENTER PC
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 2608 OLD FAIR RD
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City | GRAND ISLAND
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State | NE
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Zip | 68803-5271
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Country | US
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Telephone | 308-382-5297
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Fax | 308-382-5315
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Provider Business Mailing Address
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Address Line | 3811 29TH AVE SUITE 5
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City | KEARNEY
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State | NE
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Zip | 68845-1280
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Country | US
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Telephone | 308-455-1560
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Fax | 308-455-1450
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | MS. MICHELLE L CHOPLIN
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Credential |
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Telephone | 308-382-5297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9086
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License Number State | NE
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