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General NPI Number Information
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NPI Number | 1497511315
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Entity Type | Organization
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Legal Business Name | MIND AND BODY INTERVENTIONS
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 1205 E CAYUGA ST
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City | TAMPA
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State | FL
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Zip | 33603-4216
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Country | US
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Telephone | 386-479-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 E CAYUGA ST
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City | TAMPA
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State | FL
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Zip | 33603-4216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LISA ANNORINO
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Credential | OTR, CTRS
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Telephone | 386-479-3121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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