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Organization

MAGNOLIA HEALTH & WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WAQUIA MAULTSBY FNP (OWNER/PRACTITIONER)
(252) 320-9081
Entity
Organization

Contact information

Practice address
211 COMMERCE ST STE C, GREENVILLE, NC 27858-5030
(252) 320-9081
Mailing address
211 COMMERCE ST STE C, GREENVILLE, NC 27858-5030
(252) 320-9081

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
163W00000X
Registered Nurse
251S00000X
Community/Behavioral Health Agency
363LF0000X
Family Nurse Practitioner
363LP2300X
Primary Care Nurse Practitioner
Primary

Other

Enumeration date
04/06/2020
Last updated
04/09/2020
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