| NPI | 1447735980 |
|---|---|
| Doing Business As | PHOENIX RISING WELLNESS |
| Entity Type | Organization |
| Authorized Contact | AMBER DAWN WORMAN Owner 502-536-7187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-01 |