Restorative Mind, Restorative Body Therapeutics LLC
Social Worker, Clinical in Wilson, NC. Organization (NPI-2).
NPI number1215769880
StatusActive
Last updated in NPPESAug 14, 2024
Details
- NPI
- 1215769880
- Entity type
- Organization (NPI-2)
- Legal business name
- Restorative Mind, Restorative Body Therapeutics LLC
- Organization subpart
- No
- Enumeration date
- Aug 14, 2024
- Certification date
- Aug 14, 2024
- Last updated
- Aug 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 225700000X | Massage Therapist | – | – |
Practice location
509 Nash St W Ste BWilson, NC 27893-3744
Phone 336-695-9342
Mailing address
4630 Gallant LnWinston Salem, NC 27101-6409
Authorized official
Ashlei Brown
Member, Manager
3362874239
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