Provider Demographics
NPI:1417498502
Name:INFINITE HEALING AND WELLNESS
Entity Type:Organization
Organization Name:INFINITE HEALING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ASSOCIATE COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LEEANN
Authorized Official - Middle Name:LAI WAH
Authorized Official - Last Name:KUANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:480-785-6822
Mailing Address - Street 1:2563 S VAL VISTA DR
Mailing Address - Street 2:SUITE #108
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1804
Mailing Address - Country:US
Mailing Address - Phone:480-448-1076
Mailing Address - Fax:
Practice Address - Street 1:2563 S VAL VISTA DR
Practice Address - Street 2:SUITE #108
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1804
Practice Address - Country:US
Practice Address - Phone:480-448-1076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-16446101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty