MEDICARE: MIND BODY WITH CORY

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1336956739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND BODY WITH CORY

Provider Business Mailing Address
First Line	:	PO BOX 18
Second Line	:
City	:	CHESTER
State	:	NH
Zip	:	03036-0018
Country	:	US
Telephone Number	:	866-963-1128
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 VILLAGER RD
Second Line	:
City	:	CHESTER
State	:	NH
Zip	:	03036-4035
Country	:	US
Telephone Number	:	866-963-1128
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CORY OWENS-BATTY
Credential	:	LICSW
Telephone Number	:	866-963-1128

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	12/18/2024

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Directions to “MIND BODY WITH CORY ” Practice Location

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