Provider Demographics
NPI:1831903988
Name:WESOURCE WELLNESS LLC
Entity type:Organization
Organization Name:WESOURCE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:SHAE
Authorized Official - Last Name:CORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-385-3786
Mailing Address - Street 1:6726 RAMBLING MANOR CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6726 RAMBLING MANOR CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-6098
Practice Address - Country:US
Practice Address - Phone:619-385-3786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty