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Organization

THE MIND SPA LLC

Active
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Organization

THE MIND SPA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BIANCA FERGUSON PMHNP (NURSE PRACTITIONER)
(678) 216-7151
Entity
Organization

Contact information

Practice address
113 S PERRY ST STE 206, LAWRENCEVILLE, GA 30046-4811
(678) 216-7151
Mailing address
113 S PERRY ST STE 206, LAWRENCEVILLE, GA 30046-4811

Taxonomy

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

Other

Enumeration date
11/21/2025
Last updated
11/21/2025
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