Provider Demographics
NPI:1952137176
Name:INTUITIVE MENTAL & PHYSICAL WELLNESS LLC
Entity type:Organization
Organization Name:INTUITIVE MENTAL & PHYSICAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JEFFERS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP, PMHNP-BC
Authorized Official - Phone:937-239-5644
Mailing Address - Street 1:12 W WENGER RD STE J
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2755
Mailing Address - Country:US
Mailing Address - Phone:937-239-5644
Mailing Address - Fax:937-771-0031
Practice Address - Street 1:12 W WENGER RD STE J
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2755
Practice Address - Country:US
Practice Address - Phone:937-239-5644
Practice Address - Fax:937-771-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty