Provider Demographics
NPI:1205480993
Name:WHOLE PERSON WELLNESS, INC.
Entity type:Organization
Organization Name:WHOLE PERSON WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAN SALVADOR
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC
Authorized Official - Phone:239-826-8347
Mailing Address - Street 1:501 SE 17TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2224
Mailing Address - Country:US
Mailing Address - Phone:239-826-8347
Mailing Address - Fax:
Practice Address - Street 1:13180 N CLEVELAND AVE STE 214
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-6231
Practice Address - Country:US
Practice Address - Phone:239-826-8347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health