# HOLISTIC WELLNESS GROUP LLC

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

## Provider details

- **NPI number:** 1962199745
- **Authorized official:** EMIGDUS NKEM (DIRECTOR)
- **Authorized official phone:** (571) 494-7066

## Contact information

- **Practice address:** 6308 FIVE MILE CENTRE PARK STE 217, FREDERICKSBURG, VA 22407-5508
- **Practice address phone:** (571) 409-8390
- **Mailing address:** 12806 GLENDALE CT, FREDERICKSBURG, VA 22407-2060
- **Mailing address phone:** (571) 409-8390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/20/2023
- **Last updated:** 08/22/2023