NPI | 1609631399 |
---|---|
Doing Business As | LAELIA WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | SHAYNA MARIE RICHARDS Owner 928-350-9588 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2024-02-21 |
Last Update Date | 2024-05-20 |