| Nurture Wellness Therapy And Yoga, Llc | |
|
302 Sw 6th St Ste 10 Bentonville AR 72712-5771 | |
| (512) 592-0281 | |
| Not Available |
| Full Name | Nurture Wellness Therapy And Yoga, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 302 Sw 6th St Ste 10, Bentonville, Arkansas |
| Authorized Official Name and Position | Kelly Smith (OWNER/THERAPIST) |
| Authorized Official Contact | 5125920281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nurture Wellness Therapy And Yoga, Llc 2 Swallow Ln Bella Vista AR 72714-3238 Ph: (512) 592-0281 | Nurture Wellness Therapy And Yoga, Llc 302 Sw 6th St Ste 10 Bentonville AR 72712-5771 Ph: (512) 592-0281 |
| NPI Number | 1902648454 |
|---|---|
| Provider Enumeration Date | 06/06/2024 |
| Last Update Date | 06/06/2024 |
| Certification Date | 06/06/2024 |
| Medicare PECOS PAC ID | 2668917741 |
|---|---|
| Medicare Enrollment ID | O20240712002319 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902648454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Kelly A Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063757052 PECOS PAC ID: 6800220856 Enrollment ID: I20191227000420 |
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