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General NPI Number Information
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NPI Number | 1144014002
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Entity Type | Organization
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Legal Business Name | WHOLEMIND HEALING PATHWAYS
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 3613 CROSSINGS DR STE B
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City | PRESCOTT
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State | AZ
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Zip | 86305-7189
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Country | US
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Telephone | 928-550-6705
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Fax |
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Provider Business Mailing Address
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Address Line | 303 E GURLEY ST # 274
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City | PRESCOTT
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State | AZ
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Zip | 86301-3804
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Country | US
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Telephone | 928-550-6705
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JASMINE BYRD MARIE BAKER
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Credential | RN
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Telephone | 928-550-6705
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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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