Provider Demographics
NPI:1316761562
Name:ORI WELLNESS L.L.C.
Entity type:Organization
Organization Name:ORI WELLNESS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:909-436-7627
Mailing Address - Street 1:3227 75TH AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1906
Mailing Address - Country:US
Mailing Address - Phone:909-436-7627
Mailing Address - Fax:
Practice Address - Street 1:3227 75TH AVE APT 303
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-1906
Practice Address - Country:US
Practice Address - Phone:909-436-7627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty