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Organization
MINDFUL TIDES THERAPY LLC
Active
Organization
MINDFUL TIDES THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINDALL DAVIS (MANAGING PARTNER)
(724) 601-2421
Entity
Organization
Contact information
Practice address
2400 ANSYS DR, STE 102, CANONSBURG, PA 15317
(412) 737-0990
(412) 533-2696
Mailing address
2400 ANSYS DR STE 102, CANONSBURG, PA 15317-0403
(412) 737-0990
(412) 533-2696
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
04/03/2023
Last updated
01/31/2024
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