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Organization
MIND GYM NEUROFEEDBACK, LLC
Active
Organization
MIND GYM NEUROFEEDBACK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEROY MATTICKS (CEO)
(720) 290-0154
Entity
Organization
Contact information
Practice address
5322 PRIMROSE LAKE CIR STE H, TAMPA, FL 33647-3659
(720) 233-2299
Mailing address
5322 PRIMROSE LAKE CIR STE H, TAMPA, FL 33647-3659
(720) 233-2299
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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