Organization
MINDFUL WELLNESS PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN GARLAND (CONTRACTING MANAGER)
(404) 213-5329
Entity
Organization
Contact information
Practice address
7575 LEAVITT RD, AMHERST, OH 44001-2701
(440) 773-3032
Mailing address
1438 W 30TH ST, LORAIN, OH 44052-4352
(440) 773-7277
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801124730
INDIVIDUAL NPI
—
Enumeration date
12/21/2020
Last updated
12/21/2020
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