Basic Information
| Provider Information | |||||||||
| NPI: | 1710418439 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TOTAL WELLNESS ADVOCATES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 INEICHEN ST | ||||||||
| Address2: | |||||||||
| City: | RAYVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712693223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184177780 | ||||||||
| FaxNumber: | 3187281140 | ||||||||
| Practice Location | |||||||||
| Address1: | 114 INEICHEN ST | ||||||||
| Address2: | |||||||||
| City: | RAYVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712693223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184177780 | ||||||||
| FaxNumber: | 3187281140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2017 | ||||||||
| LastUpdateDate: | 03/24/2017 | ||||||||
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| AuthorizedOfficialLastName: | CARR | ||||||||
| AuthorizedOfficialFirstName: | ANASTASIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MHS | ||||||||
| AuthorizedOfficialTelephone: | 3182439218 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.