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General NPI Number Information
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NPI Number | 1083221543
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Entity Type | Organization
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Legal Business Name | NU MINDSET PLLC
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Dates
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Enumeration Date | 09/29/2020
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 2311 SHELBY AVE STE 101
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City | ANN ARBOR
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State | MI
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Zip | 48103-3849
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Country | US
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Telephone | 810-522-7419
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 924
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City | GRASS LAKE
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State | MI
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Zip | 49240-0924
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Country | US
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Telephone | 810-522-7419
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | KELLY TATARELLI-MULLINS
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Credential |
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Telephone | 810-522-7419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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