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NPI Code Detail

MEDICARE: MINDFUL THERAPEUTICS, LLC

MEDICARE: MINDFUL THERAPEUTICS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH9238FL

General Provider Information

NPI Number : 1063713493
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINDFUL THERAPEUTICS, LLC
Provider Business Mailing Address
First Line : 10621 AIRPORT PULLING RD N
Second Line : SUITE 7
City : NAPLES
State : FL
Zip : 34109-7333
Country : US
Telephone Number : 239-784-1080
Fax Number :
Provider Business Practice Location Address
First Line : 10621 AIRPORT PULLING RD N
Second Line : SUITE 7
City : NAPLES
State : FL
Zip : 34109-7333
Country : US
Telephone Number : 239-784-1080
Fax Number :
Authorized Official
Title or Position : CLINICIAN
Name : MRS. NANCY J FAIGHT-TARRETE
Credential : LMHC
Telephone Number : 239-784-1080
Provider Enumeration Date : 11/17/2010
Last Update Date : 11/17/2010

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Directions to “MINDFUL THERAPEUTICS, LLC ” Practice Location

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