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General NPI Number Information
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NPI Number | 1194101113
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Entity Type | Organization
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Legal Business Name | THE TRANQUIL MIND INSTITUTE
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 30 CHESTNUT CIRCLE
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 908-217-4554
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Fax |
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Provider Business Mailing Address
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Address Line | 19 WEST 34 TH STREET
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City | NEW
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State | NY
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Zip | 10001
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Country | US
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Telephone | 908-217-4554
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CAROL VALENTIN
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Credential | PH.D.
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Telephone | 908217455447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 8318
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License Number State | NY
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