Organization
HOLISTICALLY TAILORED WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIA MONIQUE HALE LISW-S (CO-OWNER)
(513) 571-7850
Entity
Organization
Contact information
Practice address
312 SHARON CT, MIDDLETOWN, OH 45042-4947
(513) 393-9761
Mailing address
312 SHARON CT, MIDDLETOWN, OH 45042-4947
(513) 571-7850
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0441541
—
OH
Enumeration date
04/13/2021
Last updated
08/02/2021
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