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General NPI Number Information
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NPI Number | 1013430727
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Entity Type | Organization
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Legal Business Name | MINDFUL HEALTH & WELLNESS, LLC
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 515 E MAIN ST
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City | ENDICOTT
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State | NY
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Zip | 13760-5023
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Country | US
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Telephone | 607-444-3318
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Fax | 607-444-3319
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Provider Business Mailing Address
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Address Line | 515 E MAIN ST
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City | ENDICOTT
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State | NY
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Zip | 13760-5023
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Country | US
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Telephone | 607-444-3318
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Fax | 607-444-3319
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. GINA TORTO
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Credential | PSY.D.
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Telephone | 607-444-3318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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