| White Owl Wellness Llc | |
|
151 Route 10 Ste 106 Succasunna NJ 07876-1452 | |
| (973) 214-1160 | |
| Not Available |
| Full Name | White Owl Wellness Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 151 Route 10 Ste 106, Succasunna, New Jersey |
| Authorized Official Name and Position | Dana Leigh Ippolito (OWNER) |
| Authorized Official Contact | 9732141160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Owl Wellness Llc 12 Knollwood Rd Flanders NJ 07836-9306 Ph: (973) 214-1160 | White Owl Wellness Llc 151 Route 10 Ste 106 Succasunna NJ 07876-1452 Ph: (973) 214-1160 |
| NPI Number | 1366086779 |
|---|---|
| Provider Enumeration Date | 10/30/2019 |
| Last Update Date | 02/19/2020 |
| Certification Date | 02/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366086779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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