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General NPI Number Information
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NPI Number | 1841822160
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Entity Type | Organization
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Legal Business Name | EAGLE MINDSET COACHING AND COUNSELING LLC
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 10 S HIGHVIEW RD
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City | MIDDLETOWN
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State | OH
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Zip | 45044-5027
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Country | US
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Telephone | 513-869-0469
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Fax |
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Provider Business Mailing Address
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Address Line | 4964 DARTMOUTH CT
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City | HAMILTON
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State | OH
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Zip | 45011-9763
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Country | US
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Telephone | 513-869-0469
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AHJA GAY HARRIS
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Credential |
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Telephone | 513-869-0469
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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 |
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License Number State |
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