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General NPI Number Information
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NPI Number | 1225747330
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Entity Type | Organization
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Legal Business Name | MINDFUL FOUNDATIONS THERAPY LLC
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 24 SALT POND RD STE B4
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City | WAKEFIELD
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State | RI
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Zip | 02879-4320
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Country | US
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Telephone | 800-965-5607
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Fax |
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Provider Business Mailing Address
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Address Line | 3 MEADOW RIDGE RD
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City | WESTERLY
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State | RI
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Zip | 02891-4001
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Country | US
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Telephone | 401-965-5607
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Fax |
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Authorized Official
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Title or Position | PYSCHOLOGIST
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Name | DR. KARA KIRKER
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Credential |
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Telephone | 401-965-5607
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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 |
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License Number State |
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