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General NPI Number Information
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NPI Number | 1932854429
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Entity Type | Organization
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Legal Business Name | HEALING & WELLNESS, PLLC
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 1845 S DOBSON RD STE 208
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City | MESA
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State | AZ
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Zip | 85202-5663
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Country | US
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Telephone | 480-803-1500
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Fax | 602-926-2066
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Provider Business Mailing Address
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Address Line | 1845 S DOBSON RD STE 208
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City | MESA
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State | AZ
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Zip | 85202-5663
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Country | US
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Telephone | 480-803-1500
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Fax | 602-926-2066
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MS. KERRY MARIE DIANA
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Credential | LPC
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Telephone | 480-803-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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