Organization
ENLIVEN HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WAGNER (OWNER)
(614) 218-8769
Entity
Organization
Contact information
Practice address
929 HARRISON AVE STE 304, COLUMBUS, OH 43215-1346
(614) 218-8769
Mailing address
929 HARRISON AVE STE 304, COLUMBUS, OH 43215-1346
(614) 218-8769
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TH0004X
Health Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
133VN1301X
Oncology Nutrition Registered Dietitian
—
—
207QA0505X
Adult Medicine Physician
Primary
—
—
207RX0202X
Medical Oncology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
07/31/2021
Last updated
07/31/2021
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