Organization
THE MIND CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DADILINE DORCE MD, APRN (MGR)
(904) 297-8291
Entity
Organization
Contact information
Practice address
3785 RIVER RD N, KEIZER, OR 97303-5098
(503) 383-9380
Mailing address
PO BOX 57185, JACKSONVILLE, FL 32241-7185
(904) 297-8291
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
05/03/2024
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