# HOLISTIX MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487077897
- **Authorized official:** JESSICA WATKINS MSW (COO)
- **Authorized official phone:** (561) 213-4103

## Contact information

- **Practice address:** 1815 E COMMERCIAL BLVD, STE 206, FT LAUDERDALE, FL 33308-3760
- **Practice address phone:** (954) 941-3413
- **Practice address fax:** (754) 200-6283
- **Mailing address:** 1815 E COMMERCIAL BLVD, STE 206, FT LAUDERDALE, FL 33308-3760
- **Mailing address phone:** (954) 941-3413
- **Mailing address fax:** (754) 200-6283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 01/22/2014
- **Last updated:** 01/22/2014