| Healthy Resolutions Clinic Pllc | |
|
2005 Hope Mills Rd Fayetteville NC 28304-4224 | |
| (910) 257-0573 | |
| Not Available |
| Full Name | Healthy Resolutions Clinic Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2005 Hope Mills Rd, Fayetteville, North Carolina |
| Authorized Official Name and Position | Marina Johnson (OWNER) |
| Authorized Official Contact | 9102570573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Resolutions Clinic Pllc 2005 Hope Mills Rd Fayetteville NC 28304-4224 Ph: (910) 257-0573 | Healthy Resolutions Clinic Pllc 2005 Hope Mills Rd Fayetteville NC 28304-4224 Ph: (910) 257-0573 |
| NPI Number | 1841811593 |
|---|---|
| Provider Enumeration Date | 05/05/2020 |
| Last Update Date | 05/05/2020 |
| Certification Date | 05/05/2020 |
| Medicare PECOS PAC ID | 0345661377 |
|---|---|
| Medicare Enrollment ID | O20200530000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841811593 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marina Gordula Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134568801 PECOS PAC ID: 7416250931 Enrollment ID: I20160115002113 |
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