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General NPI Number Information
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NPI Number | 1083261887
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Entity Type | Organization
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Legal Business Name | A HEALTHY MIND MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 1450B PETERMAN DR
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3432
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Country | US
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Telephone | 318-299-2950
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Fax | 318-708-1015
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Provider Business Mailing Address
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Address Line | PO BOX 3352
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City | PINEVILLE
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State | LA
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Zip | 71361-3352
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Country | US
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Telephone | 318-299-2950
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC MENTAL HEALTH NURSE PRA
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Name | WAKANDA MASON
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Credential |
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Telephone | 318-299-2950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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