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General NPI Number Information
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NPI Number | 1972490118
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Entity Type | Organization
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Legal Business Name | WAKING WELLNESS LLC
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 144 BIRCH ROAD
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City | WOODFORD
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State | VT
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Zip | 05201
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Country | US
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Telephone | 971-802-1724
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1433
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City | BENNINGTON
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State | VT
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Zip | 05201-1433
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Country | US
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Telephone | 732-221-6094
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Fax |
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Authorized Official
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Title or Position | OWNER/LPC
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Name | ASHLEY DI MEO
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Credential |
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Telephone | 971-802-1724
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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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