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General NPI Number Information
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NPI Number | 1679224745
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Entity Type | Organization
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Legal Business Name | MIND OVER MATTER SOLUTIONS LLC
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 3305 KENNYS ST
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City | PINEVILLE
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State | NC
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Zip | 28134-6447
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Country | US
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Telephone | 704-222-6610
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Fax |
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Provider Business Mailing Address
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Address Line | 3305 KENNYS ST
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City | PINEVILLE
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State | NC
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Zip | 28134-6447
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Country | US
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Telephone | 704-222-6610
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DAVID JEFFERS
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Credential |
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Telephone | 704-500-7999
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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 |
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License Number State |
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