Organization
MIND-FULLY-YOURS RECOVERY & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXINE REEVES DAVIS PMHNP (NURSE PRACTITIONER)
(305) 336-2162
Entity
Organization
Contact information
Practice address
977 SW COLLEGE PARK RD, PORT ST LUCIE, FL 34953-5869
(305) 336-2162
Mailing address
977 SW COLLEGE PARK RD, PORT ST LUCIE, FL 34953-5869
(305) 336-2162
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
12/05/2024
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