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General NPI Number Information
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NPI Number | 1649888256
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Entity Type | Organization
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Legal Business Name | HEALTHY MINDS PLLC
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 40 RUSS ST
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City | HARTFORD
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State | CT
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Zip | 06106-1520
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Country | US
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Telephone | 860-544-5926
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Fax |
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Provider Business Mailing Address
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Address Line | 1161 PALISADO AVE
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City | WINDSOR
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State | CT
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Zip | 06095-1435
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Country | US
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Telephone | 860-214-5688
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER MH
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Name | MS. MARY ANN RODRIGUEZ
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Credential | PMHNP - BC
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Telephone | 860-214-5688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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