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General NPI Number Information
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NPI Number | 1760024434
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Entity Type | Organization
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Legal Business Name | MINDFUL HARMONY LLC
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 6 N. MAIN ST
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City | HOMER
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State | NY
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Zip | 13077
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Country | US
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Telephone | 607-218-2018
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Fax | 607-930-4750
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Provider Business Mailing Address
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Address Line | 67 N. MAIN ST
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City | HOMER
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State | NY
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Zip | 13077
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Country | US
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Telephone | 607-218-2018
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Fax | 607-930-4750
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | STEPHANIE KOSLOWSKI
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Credential | LAC
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Telephone | 607-218-2048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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