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General NPI Number Information
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NPI Number | 1770176034
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Entity Type | Organization
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Legal Business Name | THRIVING MINDS PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 1928 PROCTOR AVE
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City | ORLANDO
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State | FL
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Zip | 32817-4200
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Country | US
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Telephone | 407-982-2047
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Fax | 321-319-9717
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Provider Business Mailing Address
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Address Line | 1946 FILLY TRL (OPTIONAL)
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City | OVIEDO
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State | FL
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Zip | 32765
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Country | US
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Telephone | 787-685-3424
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ADRIANA GARCIA
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Credential | PSY.D.
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Telephone | 787-685-3424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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