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General NPI Number Information
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NPI Number | 1881007169
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Entity Type | Organization
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Legal Business Name | MINDFUL LIVING LLC
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 1216 SILVER AVE SW APT 3
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2986
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Country | US
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Telephone | 505-908-1953
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Fax | 505-274-7338
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Provider Business Mailing Address
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Address Line | 8205 SPAIN RD NE STE 106
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3155
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Country | US
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Telephone | 505-384-7352
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Fax | 505-217-9165
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Authorized Official
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Title or Position | OWNER
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Name | CARA HOWELL
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Credential | LMSW
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Telephone | 505-908-1953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | M-08054
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License Number State | NM
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