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General NPI Number Information
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NPI Number | 1952272163
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Entity Type | Organization
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Legal Business Name | LOVE & LIGHT WELLNESS LLC
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 30 S 15TH ST STE 1550 #140838
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City | PHILADELPHIA
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State | PA
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Zip | 19102-4806
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Country | US
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Telephone | 445-207-3784
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Fax |
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Provider Business Mailing Address
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Address Line | 30 S 15TH ST STE 1550 PMB#140838
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City | PHILADELPHIA
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State | PA
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Zip | 19102-4806
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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 | OWNER
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Name | MONIQUE ANDERSON
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Credential | LCSW
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Telephone | 267-701-1145
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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 |
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License Number State |
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