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General NPI Number Information
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NPI Number | 1851179535
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Entity Type | Organization
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Legal Business Name | MINDFUL BLESSINGS MENTAL HEALTH
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 02/11/2024
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Provider Practice Location Address
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Address Line | 1109 COLLEGE DR
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City | TEXARKANA
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State | TX
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Zip | 75503-3527
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Country | US
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Telephone | 903-225-9123
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 67
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City | BLOOMBURG
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State | TX
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Zip | 75556-0067
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Country | US
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Telephone | 903-824-1506
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. FELICIA PHAY HUDDLESTRON
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Credential | PMHNP
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Telephone | 903-225-9123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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