Healthcare Provider Details

I. General information

NPI: 1275812687
Provider Name (Legal Business Name): FLYING THRU YOUR MIND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 W. CARMEL DRIVE SUITE 220
CARMEL IN
46032
US

IV. Provider business mailing address

484 E. CARMEL DRIVE #337
CARMEL IN
46032
US

V. Phone/Fax

Practice location:
  • Phone: 317-848-5039
  • Fax:
Mailing address:
  • Phone: 317-848-5039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: LINDA J. HANDY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MINISTER (ORDAINED 2
Phone: 317-848-5039