| Holistically Tailored Wellness Center | |
|
312 Sharon Ct Middletown OH 45042-4947 | |
| (513) 393-9761 | |
| Not Available |
| Full Name | Holistically Tailored Wellness Center |
|---|---|
| Speciality | Social Worker |
| Location | 312 Sharon Ct, Middletown, Ohio |
| Authorized Official Name and Position | Tia Monique Hale (CO-OWNER) |
| Authorized Official Contact | 5135717850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistically Tailored Wellness Center 312 Sharon Ct Middletown OH 45042-4947 Ph: (513) 571-7850 | Holistically Tailored Wellness Center 312 Sharon Ct Middletown OH 45042-4947 Ph: (513) 393-9761 |
| NPI Number | 1760062723 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/02/2021 |
| Medicare PECOS PAC ID | 3971909698 |
|---|---|
| Medicare Enrollment ID | O20210903002708 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760062723 | NPI | - | NPPES |
| 0441541 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tia M Hale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114470242 PECOS PAC ID: 9234465550 Enrollment ID: I20190724003425 |
| Provider Name | Brenda Howell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205203353 PECOS PAC ID: 7618374521 Enrollment ID: I20210921001089 |
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