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Organization
MIND GYM NEUROFEEDBACK, LLC
Active
Organization
MIND GYM NEUROFEEDBACK, LLC
Active
Parent organization
MIND GYM NEUROFEEDBACK, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIND GYM NEUROFEEDBACK, LLC
Authorized official
MR. LEROY MATTICKS (CEO)
(720) 290-0154
Entity
Organization
Contact information
Practice address
730 S STERLING AVE STE 301, TAMPA, FL 33609-4524
(720) 305-6583
(720) 222-5533
Mailing address
5322 PRIMROSE LAKE CIR STE H, TAMPA, FL 33647-3659
(720) 305-6583
(720) 222-5533
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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