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Organization
MIND & BODY REBOOT, LLC
Active
Organization
MIND & BODY REBOOT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA CERRULLO PHD (FOUNDER)
(610) 465-7310
Entity
Organization
Contact information
Practice address
10 GREGORY LN, CHESTER SPRINGS, PA 19425-3314
(610) 465-7310
Mailing address
10 GREGORY LN, CHESTER SPRINGS, PA 19425-3314
(610) 213-4101
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041C0700X
HIGHMARK
PA
Enumeration date
10/05/2021
Last updated
10/05/2021
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