Organization
HOLISTIC FUNCTIONAL WELLNESS CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERWIN REYNA LCSW (PRESIDENT)
(347) 835-2989
Entity
Organization
Contact information
Practice address
12910 HARBOR DR, WOODBRIDGE, VA 22192-2930
(347) 835-2989
Mailing address
12910 HARBOR DR, WOODBRIDGE, VA 22192-2930
(347) 835-2989
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/23/2024
Last updated
01/31/2025
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