Organization
MIND TO MINDFUL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS W WOOD (OPERATIONS DIRECTOR)
(517) 759-5551
Entity
Organization
Contact information
Practice address
4190 DOUGLAS BLVD STE 300, GRANITE BAY, CA 95746-5918
(517) 759-5551
Mailing address
PO BOX 242, TECUMSEH, MI 49286-0242
(517) 759-5551
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
02/27/2019
Last updated
03/04/2019
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