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Organization
HOLISTIC WELLNESS GROUP LLC
Active
Organization
HOLISTIC WELLNESS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMIGDUS NKEM (DIRECTOR)
(571) 494-7066
Entity
Organization
Contact information
Practice address
6308 FIVE MILE CENTRE PARK STE 217, FREDERICKSBURG, VA 22407-5508
(571) 409-8390
Mailing address
12806 GLENDALE CT, FREDERICKSBURG, VA 22407-2060
(571) 409-8390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
163WI0500X
Infusion Therapy Registered Nurse
—
NULL
163WI0500X
Infusion Therapy Registered Nurse
—
—
251F00000X
Home Infusion Agency
—
NULL
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/20/2023
Last updated
08/22/2023
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