# MIND-BODY AND INNER SELF

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

## Provider details

- **NPI number:** 1629223086
- **Authorized official:** MS. ANGELA NICOLE BLAND M.S. (THERAPIST)
- **Authorized official phone:** (917) 658-9767

## Contact information

- **Practice address:** 11929 80TH RD, SUITE A, KEW GARDENS, NY 11415-1105
- **Practice address phone:** (718) 362-0615
- **Mailing address:** 11929 80TH RD, SUITE A, KEW GARDENS, NY 11415-1105
- **Mailing address phone:** (718) 362-0615

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 11/25/2008
- **Last updated:** 11/25/2008