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General NPI Number Information
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NPI Number | 1366264756
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Entity Type | Organization
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Legal Business Name | MIND OVA MATTER CONSULTING AGENCY
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 1630 E ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-2445
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Country | US
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Telephone | 202-210-1266
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 E ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-2445
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Country | US
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Telephone | 202-210-1266
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | KIANA ROBINSON
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Credential |
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Telephone | 202-210-1266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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