Healthcare Provider Details

I. General information

NPI: 1316850571
Provider Name (Legal Business Name): BODYMIND NEUROWELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BRIGHT RD
FINDLAY OH
45840-5436
US

IV. Provider business mailing address

2400 BRIGHT RD
FINDLAY OH
45840-5436
US

V. Phone/Fax

Practice location:
  • Phone: 419-701-5739
  • Fax:
Mailing address:
  • Phone: 419-889-8832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JENNIFER ANN LONG
Title or Position: PROVIDER, APRN-CNP
Credential: PMHNP-BC
Phone: 419-889-8832