Healthcare Provider Details

I. General information

NPI: 1124865449
Provider Name (Legal Business Name): MINDFULLY HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 09/11/2025
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 E 800 N
OREM UT
84097-4146
US

IV. Provider business mailing address

1341 N 3450 W
PROVO UT
84601-6200
US

V. Phone/Fax

Practice location:
  • Phone: 801-310-1096
  • Fax:
Mailing address:
  • Phone: 801-310-1096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ALMA COLON
Title or Position: OWNER THERAPIST
Credential:
Phone: 801-310-1096