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General NPI Number Information
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NPI Number | 1326796459
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Entity Type | Organization
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Legal Business Name | MINDFULNESS IN MOTION, INC
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 930 S MOUNT VERNON AVE STE 900
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City | COLTON
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State | CA
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Zip | 92324-3976
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Country | US
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Telephone | 215-678-1472
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Fax |
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Provider Business Mailing Address
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Address Line | 670 E PALM AVE
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City | REDLANDS
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State | CA
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Zip | 92374-6247
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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 | CO-OWNER
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Name | MS. DANIELLE OREFICE DELORENZO
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Credential | OTD, OTR/L
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Telephone | 215-678-1472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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