| Wholehearted Living Therapy Licensed Professional Clinical Counselor, | |
|
2030 Ontario Ct El Cajon CA 92019-4231 | |
| (619) 357-6986 | |
| Not Available |
| Full Name | Wholehearted Living Therapy Licensed Professional Clinical Counselor, |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2030 Ontario Ct, El Cajon, California |
| Authorized Official Name and Position | Michelle Vidana (OWNER) |
| Authorized Official Contact | 6193576986 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wholehearted Living Therapy Licensed Professional Clinical Counselor, 2030 Ontario Ct El Cajon CA 92019-4231 Ph: (161) 976-4329 | Wholehearted Living Therapy Licensed Professional Clinical Counselor, 2030 Ontario Ct El Cajon CA 92019-4231 Ph: (619) 357-6986 |
| NPI Number | 1487370862 |
|---|---|
| Provider Enumeration Date | 10/17/2022 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487370862 | NPI | - | NPPES |
| 5686 | Other | CA | LICENSURE NUMBER LPCC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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