Organization
MINDFUL LIVING THERAPY AND COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROCHELLE RENE GRAHAM MA, LAC (CEO)
(314) 605-0829
Entity
Organization
Contact information
Practice address
1 LATIMER WAY, BURLINGTON, NJ 08016-2930
(314) 605-0829
Mailing address
1 LATIMER WAY, BURLINGTON, NJ 08016-2930
(314) 605-0829
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/19/2019
Last updated
05/19/2019
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