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General NPI Number Information
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NPI Number | 1598037400
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Entity Type | Organization
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Legal Business Name | MIND/BODY HEALTH & PSYCHOLOGY LLC
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 6115 ESTATE SMITH BAY SUITE 334 & 335
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City | ST THOMAS
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State | VI
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Zip | 00802-1324
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Country | US
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Telephone | 340-626-8106
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12137
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City | ST THOMAS
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State | VI
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Zip | 00801-5137
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Country | US
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Telephone | 340-626-8106
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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. SHEENA MYONG WALKER
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Credential | PH.D.
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Telephone | 340-626-8106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 10-029 PSY
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License Number State | VI
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