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General NPI Number Information
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NPI Number | 1750172946
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Entity Type | Organization
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Legal Business Name | MINDFUL MATTERS MENTAL HEALTH AND WELLNESS CLINIC, PLLC
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 295 E RENFRO ST STE 300
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City | BURLESON
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State | TX
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Zip | 76028-3954
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Country | US
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Telephone | 817-969-9282
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Fax |
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Provider Business Mailing Address
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Address Line | 206 MAYBANK ST
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City | GLENN HEIGHTS
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State | TX
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Zip | 75154-8972
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Country | US
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Telephone | 318-780-4483
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | MEYATA FARLEY
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Credential | PMHNP
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Telephone | 318-780-4483
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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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