Organization
THERAPEUTIC WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUINTARA HICKS (OWNER)
(919) 809-9024
Entity
Organization
Contact information
Practice address
14420 MARITIME DR, LANCASTER, SC 29720-0256
(803) 762-0822
Mailing address
14420 MARITIME DR, LANCASTER, SC 29720-0256
(803) 762-0822
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/24/2024
Last updated
10/31/2025
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