Provider Demographics
NPI:1467898791
Name:HOLISTIC WOMEN AND FAMILIES INC
Entity Type:Organization
Organization Name:HOLISTIC WOMEN AND FAMILIES INC
Other - Org Name:HOLISTIC WOMEN AND FAMILIES NATURAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:LAVELLE
Authorized Official - Last Name:SHARE
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:386-290-9493
Mailing Address - Street 1:316 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4456
Mailing Address - Country:US
Mailing Address - Phone:386-872-5757
Mailing Address - Fax:
Practice Address - Street 1:316 DUNLAWTON AVE
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4456
Practice Address - Country:US
Practice Address - Phone:386-872-5757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2726171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty