# MIND OVER MOOD LLC

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

## Provider details

- **NPI number:** 1750159497
- **Authorized official:** MISS JAMIE KAKKANATTU CRNP (OWNER)
- **Authorized official phone:** (610) 978-6677

## Contact information

- **Practice address:** 10 BERKLEY RD, BROOMALL, PA 19008-2413
- **Practice address phone:** (610) 978-6677
- **Practice address fax:** (610) 672-4753
- **Mailing address:** 10 BERKLEY RD, BROOMALL, PA 19008-2413
- **Mailing address phone:** (610) 978-6677
- **Mailing address fax:** (610) 672-4753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/12/2023
- **Last updated:** 12/19/2023