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Organization
PHOENIX WELLNESS CENTER LLC
Active
Organization
PHOENIX WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA KINNAMAN MA, NCC, LPC (ADMINISTRATOR)
(480) 653-8434
Entity
Organization
Contact information
Practice address
2060 W WHISPERING WIND DR STE 270, PHOENIX, AZ 85085
(480) 653-8434
(623) 258-4077
Mailing address
2060 W WHISPERING WIND DR STE 270, PHOENIX, AZ 85085-2869
(480) 653-8434
(623) 258-4077
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/20/2018
Last updated
06/21/2018
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