Provider Demographics
NPI:1417570904
Name:ASASE YE DURU HOLISTIC,LLC
Entity type:Organization
Organization Name:ASASE YE DURU HOLISTIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOLISTIC THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRINAE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:251-620-9196
Mailing Address - Street 1:1201 W PEACHTREE ST NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3449
Mailing Address - Country:US
Mailing Address - Phone:833-811-5885
Mailing Address - Fax:
Practice Address - Street 1:1201 W PEACHTREE ST NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3449
Practice Address - Country:US
Practice Address - Phone:833-811-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty