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General NPI Number Information
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NPI Number | 1720806599
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Entity Type | Organization
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Legal Business Name | IRON MIND THERAPY PLLC
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 01/03/2026
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Provider Practice Location Address
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Address Line | 41700 GARDENBROOK RD STE 110
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City | NOVI
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State | MI
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Zip | 48375-1320
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Country | US
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Telephone | 248-429-7309
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Fax |
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Provider Business Mailing Address
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Address Line | 143 CADYCENTRE # 161
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City | NORTHVILLE
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State | MI
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Zip | 48167-1119
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN ATALLAH
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Credential |
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Telephone | 248-429-7309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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