Organization
MINDBODYSOUL MENTAL HEALTH & FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH FUAJONG NGULEFAC (NP)
(757) 706-1776
Entity
Organization
Contact information
Practice address
1766 LAWRENCEVILLE HWY, DECATUR, GA 30033-5641
(470) 746-3142
(404) 478-8864
Mailing address
1766 LAWRENCEVILLE HWY, DECATUR, GA 30033-5641
(470) 746-3142
(404) 478-8864
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/24/2022
Last updated
05/13/2026
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