Provider Demographics
NPI:1285929943
Name:HOLISTIC WELLNESS CONSULTING LLC
Entity type:Organization
Organization Name:HOLISTIC WELLNESS CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-704-3166
Mailing Address - Street 1:PO BOX 1866
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32790-1866
Mailing Address - Country:US
Mailing Address - Phone:407-704-3166
Mailing Address - Fax:
Practice Address - Street 1:2431 ALOMA AVE
Practice Address - Street 2:SUITE 251
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9999
Practice Address - Country:US
Practice Address - Phone:407-704-3166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7458103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty