Provider Demographics
NPI:1568715837
Name:EGOWORKZ
Entity Type:Organization
Organization Name:EGOWORKZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NLP PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:NLP
Authorized Official - Phone:540-678-3629
Mailing Address - Street 1:419 SHENANDOAH PL
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-5163
Mailing Address - Country:US
Mailing Address - Phone:540-678-3629
Mailing Address - Fax:
Practice Address - Street 1:419 SHENANDOAH PL
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5163
Practice Address - Country:US
Practice Address - Phone:540-678-3629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA10-00012330251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health