Healthcare Provider Details
I. General information
NPI: 1700694221
Provider Name (Legal Business Name): MINDFUL REFLECTIONS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7142 ROYAL GEORGE CT
WESLEY CHAPEL FL
33545-8265
US
IV. Provider business mailing address
7142 ROYAL GEORGE CT
WESLEY CHAPEL FL
33545-8265
US
V. Phone/Fax
- Phone: 813-600-0690
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ASHLEY
NICOLE
DUNNE
Title or Position: OWNER/CLINICIAN
Credential: MA, LMHC, CRC
Phone: 813-600-0690