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General NPI Number Information
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NPI Number | 1215781687
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Entity Type | Organization
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Legal Business Name | A HEALTHY MIND, LLC
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Dates
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Enumeration Date | 04/12/2024
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 315 E MAIN ST UNIT 117
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City | FERNLEY
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State | NV
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Zip | 89408-2804
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Country | US
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Telephone | 775-404-1110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 117
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City | FERNLEY
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State | NV
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Zip | 89408-0117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | NICOLE BARONA
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Credential |
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Telephone | 702-439-8687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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