NPI | 1568200400 |
---|---|
Doing Business As | WELLNESS INTENSIVE OUTPATIENT PROGRAM PC |
Entity Type | Organization |
Authorized Contact | TIMOTHY WELKE COO 747-998-0382 |
Organization Subpart ? | No |
Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
Enumeration Date | 2024-07-16 |
Last Update Date | 2024-07-16 |