Provider Demographics
NPI:1679808141
Name:PATH TO WELLNESS, INC.
Entity Type:Organization
Organization Name:PATH TO WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARI
Authorized Official - Middle Name:E
Authorized Official - Last Name:BLOING-HART
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:803-260-1171
Mailing Address - Street 1:334 OLD CHAPIN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8801
Mailing Address - Country:US
Mailing Address - Phone:803-260-1171
Mailing Address - Fax:803-359-7869
Practice Address - Street 1:334 OLD CHAPIN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-8801
Practice Address - Country:US
Practice Address - Phone:803-260-1171
Practice Address - Fax:803-359-7869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6070251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health