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General NPI Number Information
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NPI Number | 1861220238
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Entity Type | Organization
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Legal Business Name | MINDFUL HEALING, LLC
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 7901 4TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 904-468-7675
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Fax | 904-656-5094
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Provider Business Mailing Address
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Address Line | 353 SAW PALMETTO ST
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City | YULEE
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State | FL
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Zip | 32097-0098
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Country | US
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Telephone | 904-703-6261
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Fax |
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Authorized Official
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Title or Position | APRN/PMHNP/OWNER
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Name | STEPHEN MAY
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Credential |
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Telephone | 904-468-7675
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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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