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Organization
MIND-BODY AND INNER SELF
Active
Organization
MIND-BODY AND INNER SELF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA NICOLE BLAND M.S. (THERAPIST)
(917) 658-9767
Entity
Organization
Contact information
Practice address
11929 80TH RD, SUITE A, KEW GARDENS, NY 11415-1105
(718) 362-0615
Mailing address
11929 80TH RD, SUITE A, KEW GARDENS, NY 11415-1105
(718) 362-0615
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
NULL
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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