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General NPI Number Information
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NPI Number | 1841984127
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Entity Type | Organization
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Legal Business Name | EUNIQUE MIND AND MENTAL WELLNESS
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 3321B CANDELARIA RD NE # 319
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-1908
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Country | US
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Telephone | 505-270-8240
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Fax |
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Provider Business Mailing Address
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Address Line | 21750 HARDY OAK BLVD STE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4946
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TRISTAR MBC
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Credential |
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Telephone | 386-703-9084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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