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General NPI Number Information
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NPI Number | 1104703263
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Entity Type | Organization
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Legal Business Name | WHOLE MIND AND BODY WELLNESS LLC
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1500 N UNIVERSITY DR # 201GH
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8914
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Country | US
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Telephone | 561-591-7820
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 N UNIVERSITY DR # 201GH
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8914
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | BRIANA HAIGHT
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Credential |
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Telephone | 561-560-9927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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