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General NPI Number Information
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NPI Number | 1447132337
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Entity Type | Organization
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Legal Business Name | MINDSCAPE ABC LLC
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1011 SANDUSKY ST STE 1
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City | PERRYSBURG
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State | OH
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Zip | 43551-3126
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Country | US
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Telephone | 419-494-6656
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 SANDUSKY ST STE 1
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City | PERRYSBURG
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State | OH
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Zip | 43551-3126
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Country | US
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Telephone | 419-494-6656
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Fax |
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Authorized Official
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Title or Position | M. ED, ED. S
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Name | WESLEY KONESKY
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Credential |
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Telephone | 419-494-6656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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