Healthcare Provider Details
I. General information
NPI: 1801745385
Provider Name (Legal Business Name): MINDFULLY FIT WELLNESS AND PSYCHIATRY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
929 W SUNSET BLVD SUITE 21
SAINT GEORGE UT
84770
US
IV. Provider business mailing address
929 W SUNSET BLVD STE 21
ST GEORGE UT
84770-4867
US
V. Phone/Fax
- Phone: 385-446-0018
- Fax: 385-503-3782
- Phone: 385-446-0018
- Fax: 385-503-3782
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
IESHA
IWOBI
Title or Position: CEO
Credential: PA
Phone: 385-446-0018