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General NPI Number Information
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NPI Number | 1346911757
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Entity Type | Organization
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Legal Business Name | MINDSETMATTERS LLC
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Dates
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Enumeration Date | 09/24/2021
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 300 GLENN AVE
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City | EGG HARBOR TOWNSHIP
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State | NJ
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Zip | 08234-6206
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Country | US
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Telephone | 877-345-6275
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Fax | 609-641-4560
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Provider Business Mailing Address
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Address Line | 3121 D#178 FIRE ROAD
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City | EGG HARBOR TOWNSHIP
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State | NJ
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Zip | 08234
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Country | US
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Telephone | 609-816-0731
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE RENEE BROWN
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Credential | BA PSYCHOLOGY
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Telephone | 609-816-9282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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