Provider Demographics
NPI:1619561487
Name:WHOLISTIC THERAPEUTIC SERVICES, LLC
Entity Type:Organization
Organization Name:WHOLISTIC THERAPEUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LALANNE-JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:561-952-6972
Mailing Address - Street 1:1856 N NOB HILL RD # 207
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-6548
Mailing Address - Country:US
Mailing Address - Phone:561-952-6972
Mailing Address - Fax:954-901-2737
Practice Address - Street 1:2130 NW 99 WAY
Practice Address - Street 2:
Practice Address - City:SUNSRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-6548
Practice Address - Country:US
Practice Address - Phone:561-952-6872
Practice Address - Fax:954-901-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty