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General NPI Number Information
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NPI Number | 1922596675
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Entity Type | Organization
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Legal Business Name | WELLNESS WITHIN, INC.
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 1770 N PARHAM RD STE 102
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City | RICHMOND
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State | VA
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Zip | 23229-4658
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Country | US
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Telephone | 804-256-3355
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 N PARHAM RD STE 102
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City | RICHMOND
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State | VA
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Zip | 23229-4658
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Country | US
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Telephone | 804-256-3355
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | NEEMA MOORE
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Credential | DC
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Telephone | 804-247-6181
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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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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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