Organization
BEAUTIFUL MOON HEALTH & WELLNESS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAVONNI HENDERSON LCSW (OWNER)
(510) 256-9794
Entity
Organization
Contact information
Practice address
19590 E MAINSTREET STE 202, PARKER, CO 80138-7371
(720) 544-3801
Mailing address
18121 E HAMPDEN AVE STE C1079, AURORA, CO 80013-3590
(720) 544-3801
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
172M00000X
Mechanotherapist
—
—
Other
Enumeration date
10/18/2023
Last updated
12/15/2023
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