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General NPI Number Information
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NPI Number | 1548759715
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Entity Type | Organization
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Legal Business Name | 4MIND2BODY THERAPEUTIC INSTITUTE L.L.C.
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Dates
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Enumeration Date | 05/03/2018
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 5 BEEMAN PL
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1337
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Country | US
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Telephone | 973-525-2314
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Fax | 973-786-4260
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Provider Business Mailing Address
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Address Line | 5 BEEMAN PL
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1337
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Country | US
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Telephone | 973-525-2314
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Fax | 973-786-4260
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY THERAP
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Name | MRS. NARDA LUDENA
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Credential | MA/ED.S-LMFT
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Telephone | 973-525-2314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37FI00177300
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License Number State | NJ
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