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General NPI Number Information
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NPI Number | 1912525213
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Entity Type | Organization
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Legal Business Name | A BEAUTIFUL MIND THERAPY SERVICES PLLC
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 91 N SAGINAW ST STE G-101
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City | PONTIAC
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State | MI
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Zip | 48342-2165
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Country | US
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Telephone | 586-646-8259
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Fax | 586-685-2475
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Provider Business Mailing Address
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Address Line | 91 N SAGINAW ST STE G-101
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City | PONTIAC
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State | MI
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Zip | 48342-2165
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Country | US
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Telephone | 248-977-5272
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Fax | 586-685-2475
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Authorized Official
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Title or Position | CEO
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Name | SHERITA INEZ BROWNLEE
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Credential |
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Telephone | 248-977-5272
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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 |
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License Number State |
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