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Organization
IDEAL MINDSET LLC
Active
Organization
IDEAL MINDSET LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAH T PORTER DNP, APRN, PMHNP-BC (REGISTERED AGENT/MEMBER)
(801) 999-1384
Entity
Organization
Contact information
Practice address
STAPLES CONNECT OGDEN 0703, 4043 RIVERDALE RD. #1138, OGDEN, UT 84405
(801) 999-1384
(385) 364-4055
Mailing address
STAPLES CONNECT OGDEN 0703, 4043 RIVERDALE RD. #1138, OGDEN, UT 84405
(801) 999-1384
(385) 364-4055
Taxonomy
Speciality
Code
Description
License number
State
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
NULL
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
04/28/2023
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