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Organization
MIND ABOVE MATTER
Active
Organization
MIND ABOVE MATTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY MOLINA (BUSINESS OFFICE DIRECTOR)
(817) 447-3001
Entity
Organization
Contact information
Practice address
2915 S BURLESON BLVD, BURLESON, TX 76028-1878
(817) 447-3001
Mailing address
4232 HERITAGE TRACE PKWY, FORT WORTH, TX 76244-5375
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
72179
TX
Other
Enumeration date
05/18/2016
Last updated
05/19/2016
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