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Organization
BECOMING WHOLE CHRISTIAN WELLNESS, PLLC
Active
Organization
BECOMING WHOLE CHRISTIAN WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY TAFAO LADC/MH, LSATP (OWNER, PROVIDER)
(405) 315-5953
Entity
Organization
Contact information
Practice address
201 INCHON RD, FORT LEE, VA 23801-1464
(405) 315-5953
Mailing address
201 INCHON RD, FORT LEE, VA 23801-1464
(254) 833-0003
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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