| NPI | 1831833672 |
|---|---|
| Former Legal Business Name | REBELLIOUS WELLNESS |
| Entity Type | Organization |
| Authorized Contact | ANGELA M KELLER Owner 484-599-6420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2022-04-27 |