Healthcare Provider Details

I. General information

NPI: 1861250706
Provider Name (Legal Business Name): HARMONIOUS MIND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 WASHINGTON ST STE 210
WELLESLEY MA
02481-1817
US

IV. Provider business mailing address

42 WASHINGTON ST STE 210
WELLESLEY MA
02481-1817
US

V. Phone/Fax

Practice location:
  • Phone: 781-431-2629
  • Fax:
Mailing address:
  • Phone: 781-431-2629
  • 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: CHRISTINE GOSSELIN
Title or Position: OWNER
Credential:
Phone: 781-431-2629