Healthcare Provider Details

I. General information

NPI: 1063245090
Provider Name (Legal Business Name): MINDFULNESS UNVEILING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1146 HEBER AVE APT D5
HEBER CA
92249-9733
US

IV. Provider business mailing address

1146 HEBER AVE APT D5
HEBER CA
92249-9733
US

V. Phone/Fax

Practice location:
  • Phone: 713-291-2714
  • Fax: 719-283-7966
Mailing address:
  • Phone: 713-291-2714
  • Fax: 719-283-7966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHIKE SIMEON AMAH
Title or Position: OWNER
Credential:
Phone: 713-291-2714