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General NPI Number Information
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NPI Number | 1679487276
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Entity Type | Organization
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Legal Business Name | MINDFUL GROWTH WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 9440 VISCOUNT BLVD STE 203
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City | EL PASO
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State | TX
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Zip | 79925-7034
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Country | US
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Telephone | 915-229-6447
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Fax |
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Provider Business Mailing Address
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Address Line | 9440 VISCOUNT BLVD STE 203
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City | EL PASO
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State | TX
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Zip | 79925-7034
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Country | US
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Telephone | 915-229-6447
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Fax |
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Authorized Official
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Title or Position | LPC OWNER
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Name | MARIA ISABEL RIVERA
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Credential | LPC
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Telephone | 915-229-6447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | NULL
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