Organization
BLUE WAVES THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE KIM (OWNER)
(828) 448-4366
Entity
Organization
Contact information
Practice address
4111E ROSE LAKE DR # 7888, CHARLOTTE, NC 28217-2858
(828) 278-8262
Mailing address
5466 AZALEA TRCE, TRUSSVILLE, AL 35173-6320
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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