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General NPI Number Information
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NPI Number | 1306758362
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Entity Type | Organization
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Legal Business Name | MINDFUL MOTION THERAPY CO
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 6700 RIDGEMIST LN
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-2294
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Country | US
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Telephone | 501-631-0213
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Fax |
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Provider Business Mailing Address
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Address Line | 6700 RIDGEMIST LN
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-2294
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Country | US
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Telephone | 501-631-0213
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | TRISTINA WILLIAMS
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Credential | LAC
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Telephone | 501-631-0213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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