Organization
THE WELLNESS COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BRIGGS DAVIS CSW-PIP (OWNER)
(605) 271-5640
Entity
Organization
Contact information
Practice address
2333 W 57TH ST STE 103, SIOUX FALLS, SD 57108-5054
(605) 271-5640
Mailing address
2333 W 57TH ST STE 103, SIOUX FALLS, SD 57108-5054
(605) 271-5640
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922396027
—
SD
01
—
S50694
MEDICARE
SD
Enumeration date
05/13/2020
Last updated
10/03/2020
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