Organization
THE WELLNESS COLLABORATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN ERIC SMITH PHD, LMFT (OWNER)
(757) 412-7753
Entity
Organization
Contact information
Practice address
1664 CHESTWOOD DR, VIRGINIA BEACH, VA 23453-7064
(757) 412-7753
(757) 301-6920
Mailing address
PO BOX 6892, VIRGINIA BEACH, VA 23456-0892
(757) 412-7753
(757) 301-6920
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0717001246
VA
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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