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General NPI Number Information
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NPI Number | 1851269864
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Entity Type | Organization
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Legal Business Name | BODY MIND SOUL HEALING LLC
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 2410 MYSTIC TRL
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City | ROWLETT
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State | TX
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Zip | 75088-2428
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Country | US
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Telephone | 214-616-0084
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Fax |
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Provider Business Mailing Address
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Address Line | 2410 MYSTIC TRL
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City | ROWLETT
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State | TX
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Zip | 75088-2428
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Country | US
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Telephone | 214-616-0084
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MORENIKE NAOMI SALONE OLORUNNISOMO
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Credential | LPC
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Telephone | 469-200-3419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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