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Organization
MINDFULNESS, LLC
Active
Organization
MINDFULNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSRIC A MALONE-PRIOLEAU APRN, CRC (OWNER)
(304) 699-1419
Entity
Organization
Contact information
Practice address
210 2ND ST, SAINT MARYS, WV 26170-1097
(740) 371-0238
Mailing address
210 2ND ST, SAINT MARYS, WV 26170-1097
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
78769
WV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
78769
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932416179
INDIVIDUAL NPI
WV
05
—
3810023137
—
WV
Enumeration date
05/15/2018
Last updated
11/05/2018
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