Organization
MINDBODYSOUL PSYCHIATRY NP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMAN HINES (OWNER/AUTHORIZED OFFICIAL)
(914) 267-5847
Entity
Organization
Contact information
Practice address
909 MIDLAND AVE, YONKERS, NY 10704-1092
(914) 267-5847
Mailing address
516 LOCUST ST APT 4G, MOUNT VERNON, NY 10552-2774
(914) 267-5847
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
05/11/2023
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