Provider Demographics
NPI:1992693121
Name:WILLOWS WELLNESS COACHING
Entity type:Organization
Organization Name:WILLOWS WELLNESS COACHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH & WELLNESS COACH
Authorized Official - Prefix:
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, NBC-HWC
Authorized Official - Phone:916-658-3409
Mailing Address - Street 1:4204 HARBOR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-9708
Mailing Address - Country:US
Mailing Address - Phone:916-658-3409
Mailing Address - Fax:
Practice Address - Street 1:4204 HARBOR LAKE DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-9708
Practice Address - Country:US
Practice Address - Phone:916-658-3409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty