| NPI | 1962201764 |
|---|---|
| Doing Business As | ILLUMINA WELLNESS |
| Entity Type | Organization |
| Authorized Contact | RORY MCDONOUGH President 516-468-8123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-03-12 |