Mind Body And Soul LLC
Counselor, Professional in Las Vegas, NV. Organization (NPI-2).
NPI number1508325366
StatusActive
Last updated in NPPESMar 19, 2019
Details
- NPI
- 1508325366
- Entity type
- Organization (NPI-2)
- Legal business name
- Mind Body And Soul LLC
- Organization subpart
- No
- Enumeration date
- Mar 19, 2019
- Last updated
- Mar 19, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – |
Practice location
1405 San Juan Hills Dr Unit 105Las Vegas, NV 89134-6390
Phone 770-341-4402
Mailing address
1405 San Juan Hills Dr Unit 105Las Vegas, NV 89134-6390
Authorized official
Jeffrey Carson
Ceo
7703644402
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