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General NPI Number Information
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NPI Number | 1164938775
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Entity Type | Organization
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Legal Business Name | MINDFUL TRANSFORMATIONS, LLC
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 1015 S MAIN ST
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City | BEL AIR
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State | MD
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Zip | 21014-5412
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Country | US
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Telephone | 667-231-4286
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 S MAIN ST
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City | BEL AIR
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State | MD
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Zip | 21014-5412
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Country | US
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Telephone | 667-231-4286
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAREN POEHLMAN
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Credential | LCPC
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Telephone | 667-231-4286
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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 | LC2933
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License Number State | MD
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