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Organization

RENEWED THERAPY & WELLNESS CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WAJAHATUDDIN MACCI (DIRECTOR)
(773) 817-5928
Entity
Organization

Contact information

Practice address
12712 W LAKE HOUSTON PKWY STE B4136, HOUSTON, TX 77044-6467
(850) 625-1788
Mailing address
343 N WOOD DALE RD STE 201A, WOOD DALE, IL 60191-1578
(773) 817-5928

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary

Other

Enumeration date
03/27/2023
Last updated
03/27/2023
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