Inner Wellth LLC
NPI #1992077622 in Mountain Lakes, New Jersey
Provider Information
- NPI Number
- 1992077622
- Entity Type
- Organization
- Organization Name
- Inner Wellth LLC
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jan 26, 2012
- Last Updated
- Jan 26, 2012
Practice Location
- Address
- 420 BOULEVARD
- Address 2
- SUITE 101
- City
- Mountain Lakes
- State
- New Jersey
- ZIP Code
- 07046-1742
- Phone
- (973) 321-4380
Authorized Official
- Name
- DR. RANDOLPH SCOTT SHIPON, PH.D.
- Title
- MEMBER
- Phone
- (973) 321-4380
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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