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General NPI Number Information
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NPI Number | 1356177612
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Entity Type | Organization
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Legal Business Name | MERRY MIND WELLNESS, LLC
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 11/28/2024
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Provider Practice Location Address
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Address Line | 53 DARBY RD STE Z
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City | PAOLI
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State | PA
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Zip | 19301-1472
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Country | US
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Telephone | 201-657-0127
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Fax |
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Provider Business Mailing Address
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Address Line | 53 DARBY RD STE Z
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City | PAOLI
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State | PA
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Zip | 19301-1472
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Country | US
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Telephone | 610-500-6355
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Fax | 252-300-3738
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Authorized Official
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Title or Position | OWNER
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Name | MS. MEREDITH LEIGH MCPHERSON
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Credential | CRNP, PMHNP-BC
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Telephone | 610-500-6355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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