Provider Demographics
NPI:1932854429
Name:HEALING & WELLNESS, PLLC
Entity Type:Organization
Organization Name:HEALING & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DIANA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-803-1500
Mailing Address - Street 1:1845 S DOBSON RD STE 208
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-5663
Mailing Address - Country:US
Mailing Address - Phone:480-803-1500
Mailing Address - Fax:602-926-2066
Practice Address - Street 1:1845 S DOBSON RD STE 208
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5663
Practice Address - Country:US
Practice Address - Phone:480-803-1500
Practice Address - Fax:602-926-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty