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General NPI Number Information
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NPI Number | 1780128835
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL MIND PSYCHIATRIC MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 99 DERBY ST SUITE 200, OFFICE 213
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City | HINGHAM
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State | MA
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Zip | 02043-4216
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Country | US
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Telephone | 781-556-1013
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Fax | 781-885-0397
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Provider Business Mailing Address
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Address Line | 99 DERBY ST SUITE 200, OFFICE 213
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City | HINGHAM
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State | MA
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Zip | 02043-4216
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Country | US
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Telephone | 781-556-1013
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Fax | 781-885-0397
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Authorized Official
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Title or Position | NURSE PRACTITIONER/ENTREPRENEUR
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Name | MURIANA JEANNITON
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Credential | PMHNP-BC
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Telephone | 781-540-8541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | RN270513
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License Number State | MA
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