Organization
MINDFUL SELF CARE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA S GILL PHD (OWNER)
(973) 820-5174
Entity
Organization
Contact information
Practice address
46 UNDERWOOD DR, WEST ORANGE, NJ 07052-1323
(973) 820-5174
Mailing address
7140 PROSPERITY CIR, SARASOTA, FL 34238-1503
(973) 820-5174
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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