# MIND BODY SPIRIT WELLNESS INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508138561
- **Authorized official:** MAIYSHA TANIA CLAIRBORNE MD (PRESIDENT/CEO)
- **Authorized official phone:** (404) 478-9868

## Contact information

- **Practice address:** 2801 BUFORD HWY NE STE T65, ATLANTA, GA 30329-2145
- **Practice address phone:** (404) 478-9868
- **Mailing address:** 2484 BRIARCLIFF RD NE STE 22-315, ATLANTA, GA 30329-3011
- **Mailing address phone:** (404) 478-9868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 055194 | GA | Yes |
| 261QP2300X | Primary Care Clinic/Center | 055194 | GA | — |

## Other

- **Enumeration date:** 02/06/2012
- **Last updated:** 02/06/2012