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General NPI Number Information
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NPI Number | 1801795794
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Entity Type | Organization
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Legal Business Name | HALO MIND PSYCHIATRY AND LONGEVITY WELLNESS
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 653 ROBERTS DR STE A9
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City | RIVERDALE
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State | GA
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Zip | 30274-2959
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Country | US
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Telephone | 404-497-7898
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Fax | 404-779-7688
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Provider Business Mailing Address
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Address Line | 653 ROBERTS DR STE A9
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City | RIVERDALE
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State | GA
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Zip | 30274-2959
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Country | US
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Telephone | 404-497-7898
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Fax | 404-779-7688
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Authorized Official
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Title or Position | OWNER
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Name | ADREONNE LEWIS HOUSTON
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Credential | FNP
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Telephone | 404-497-7898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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