Organization
NURTURED RADIANCE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANASTASIA GIBSON (OWNER)
(845) 665-2888
Entity
Organization
Contact information
Practice address
405 KNIGHTDALE STATION RUN, KNIGHTDALE, NC 27545-7288
(845) 665-2888
Mailing address
42 CHAPARRAL TRL, GARNER, NC 27529-6655
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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