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General NPI Number Information
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NPI Number | 1184373128
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Entity Type | Organization
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Legal Business Name | MIGHTY MINDS THERAPY, LLC
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Dates
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Enumeration Date | 03/18/2022
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 10200 SW 103RD CT
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City | MIAMI
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State | FL
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Zip | 33176-3518
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Country | US
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Telephone | 786-853-7106
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Fax |
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Provider Business Mailing Address
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Address Line | 10200 SW 103RD CT
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City | MIAMI
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State | FL
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Zip | 33176-3518
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Country | US
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Telephone | 786-853-7106
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. ADRIANA M MARINO
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Credential | M.S., CCC-SLP
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Telephone | 786-853-7106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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