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Contact Information

RADICAL WELLNESS PLLC
4729 US-98 S
SUITE 104
LAKELAND, FL33812
 Phone: 813-444-7576
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counseling

103TC1900X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for RADICAL WELLNESS PLLC · (Female)

NPI Number 1033849815
Status Active
Credentials
Entity Individual
Enumeration date 06/14/2022
Last updated 06/14/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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