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General NPI Number Information
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NPI Number | 1164233763
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Entity Type | Organization
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Legal Business Name | BETTERMIND WELLNESS LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 4879 CRYSTAL CREEK LN
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City | WASHINGTON
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State | MI
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Zip | 48094-4216
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Country | US
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Telephone | 586-495-6021
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Fax |
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Provider Business Mailing Address
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Address Line | 18623 LONDON DR
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City | MACOMB
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State | MI
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Zip | 48042-6216
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Country | US
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Telephone | 586-495-6021
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KOMAL FARRUKH
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Credential |
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Telephone | 586-495-6021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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