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General NPI Number Information
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NPI Number | 1235906553
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Entity Type | Organization
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Legal Business Name | MATTERS OF THE MIND
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 1401 MALVERN AVE STE 152
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City | HOT SPRINGS
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State | AR
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Zip | 71901-6370
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Country | US
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Telephone | 501-463-0209
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20512
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City | HOT SPRINGS
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State | AR
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Zip | 71903-0512
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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 | OWNER
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Name | CRISTINA PUCKETT
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Credential | LCSW, LISW, LSCSW
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Telephone | 501-463-0209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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