Organization
BODHI MIND AND BODY WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY ANN SMITH LCSW (CLINICAL DIRECTOR)
(908) 910-5414
Entity
Organization
Contact information
Practice address
1715 UNION AVE FL 2, HAZLET, NJ 07730-2443
(908) 910-5414
Mailing address
146 MAIN ST, PORT MONMOUTH, NJ 07758-1341
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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