MEDICARE: HOLISTIC WELLNESS INSTITUTE,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1245542885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC WELLNESS INSTITUTE,INC

Provider Business Mailing Address
First Line	:	PO BOX 9244
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-0244
Country	:	US
Telephone Number	:	614-307-9561
Fax Number	:

Provider Business Practice Location Address
First Line	:	2234 S HAMILTON RD
Second Line	:	SUITE 102
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4389
Country	:	US
Telephone Number	:	614-307-9561
Fax Number	:

Authorized Official
Title or Position	:	CEO/THERAPIST
Name	:	EDITH MARIE GREEN
Credential	:	LPC
Telephone Number	:	614-307-9561

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	07/12/2010

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