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General NPI Number Information
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NPI Number | 1922788314
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Entity Type | Organization
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Legal Business Name | MINDFUL FAMILY WELLNESS, LLC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 500 S MAIN ST STE 113
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City | MOORESVILLE
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State | NC
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Zip | 28115-3228
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Country | US
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Telephone | 704-775-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 595 BEATEN PATH RD
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City | MOORESVILLE
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State | NC
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Zip | 28117-8982
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Country | US
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Telephone | 704-775-9300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA DUERR
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Credential | LN, CNS
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Telephone | 704-775-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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