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General NPI Number Information
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NPI Number | 1003544123
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Entity Type | Organization
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Legal Business Name | RESTFUL MIND MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 522 W RIVERSIDE AVE STE 4830
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 908-548-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 5130 TRUMPET VINE WAY
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City | WILMINGTON
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State | NC
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Zip | 28412-6263
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Country | US
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Telephone | 908-548-3600
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DMITRY TVERSKOY
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Credential | APRN
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Telephone | 908-548-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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