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NPI 1376419317

NPI 1376419317 : MINDS OVER MATTER, LLC : GRAND LEDGE, MI

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General NPI Number Information
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    NPI Number           |    1376419317
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    Entity Type          |    Organization 
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    Legal Business Name  |    MINDS OVER MATTER, LLC 
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Dates
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    Enumeration Date     |    10/16/2025
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    Last Update Date     |    11/07/2025
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Provider Practice Location Address
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    Address Line         |    316 TAYLOR ST 
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    City                 |    GRAND LEDGE
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    State                |    MI
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    Zip                  |    48837-1569
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    Country              |    US
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    Telephone            |    517-343-6147
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    316 TAYLOR ST 
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    City                 |    GRAND LEDGE
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    State                |    MI
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    Zip                  |    48837-1569
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    Country              |    US
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    Telephone            |    517-343-6147
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. ROBERT JAMES RODWAY 
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    Credential           |    DNP, APRN, PMHNP-BC
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    Telephone            |    517-343-6147
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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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