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General NPI Number Information
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NPI Number | 1902534589
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Entity Type | Organization
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Legal Business Name | DE-STRESSING MINDS LLC
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 3625 NW 82ND AVE STE 309
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City | DORAL
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State | FL
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Zip | 33166-7601
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Country | US
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Telephone | 786-444-1735
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Fax |
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Provider Business Mailing Address
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Address Line | 7777 SW 86 ST BLDG. F1 APT. 212
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City | MIAMI
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State | FL
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Zip | 33143
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Country | US
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Telephone | 786-444-1735
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Fax |
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Authorized Official
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Title or Position | LMHC
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Name | MR. SHANE WILSON
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Credential | MS
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Telephone | 786-444-1735
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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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