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General NPI Number Information
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NPI Number | 1437991791
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Entity Type | Organization
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Legal Business Name | MENDOLIA MARRIAGE, FAMILY, AND INDIVIDUAL PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 06/08/2024
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Last Update Date | 06/08/2024
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Provider Practice Location Address
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Address Line | 1975 PARKFRONT DR APT 403
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City | MT PLEASANT
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State | SC
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Zip | 29464-7107
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Country | US
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Telephone | 917-704-6108
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Fax |
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Provider Business Mailing Address
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Address Line | 1975 PARKFRONT DR APT 403
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City | MT PLEASANT
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State | SC
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Zip | 29464-7107
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Country | US
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Telephone | 917-704-6108
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | MS. JOANI TERESA MENDOLIA
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Credential | MFT-C
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Telephone | 917-704-6108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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