| Its Holistic Therapy Llc | |
|
6501 Arlington Expy Ste 109 Jacksonville FL 32211-5779 | |
| (904) 208-0760 | |
| Not Available |
| Full Name | Its Holistic Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6501 Arlington Expy Ste 109, Jacksonville, Florida |
| Authorized Official Name and Position | Tanitha Nicholas (OWNER) |
| Authorized Official Contact | 9042080760 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Its Holistic Therapy Llc 6501 Arlington Expy Ste 109 Jacksonville FL 32211-5779 Ph: () - | Its Holistic Therapy Llc 6501 Arlington Expy Ste 109 Jacksonville FL 32211-5779 Ph: (904) 208-0760 |
| NPI Number | 1205675329 |
|---|---|
| Provider Enumeration Date | 05/20/2024 |
| Last Update Date | 05/20/2024 |
| Certification Date | 05/20/2024 |
| Medicare PECOS PAC ID | 0749724631 |
|---|---|
| Medicare Enrollment ID | O20240702003782 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205675329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Deedra D Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184140071 PECOS PAC ID: 5991249880 Enrollment ID: I20240702003939 |
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