Healthcare Provider Details

I. General information

NPI: 1104736255
Provider Name (Legal Business Name): DEEP MINDS DEEP BONDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHESTNUT HILL PLZ
NEWARK DE
19713-2761
US

IV. Provider business mailing address

1 CHESTNUT HILL PLZ
NEWARK DE
19713-2761
US

V. Phone/Fax

Practice location:
  • Phone: 443-362-0976
  • Fax:
Mailing address:
  • Phone: 443-362-0976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: INGRID NTIEGE
Title or Position: CEO & OWNER
Credential:
Phone: 443-362-0976