Organization
MODERN WELLNESS PLLC
Active
Organization
MODERN WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTI STARR BALDWIN ROOKS MA, LPC (OWNER)
(910) 914-0011
Entity
Organization
Contact information
Practice address
1107F W BROAD ST, ELIZABETHTOWN, NC 28337-9483
(910) 862-4009
(910) 862-6004
Mailing address
PO BOX 2482, ELIZABETHTOWN, NC 28337-2482
(910) 862-4009
(910) 862-6004
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3512
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLYING FOR
—
NC
Enumeration date
05/07/2008
Last updated
05/07/2008
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