Organization
MINDFUL MATTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY LYNN VANDEN HEUVEL LCP (LICENSED PROFESSIONAL COUNSELOR)
(920) 209-0604
Entity
Organization
Contact information
Practice address
W2274 OUT OF TOWN LN, KAUKAUNA, WI 54130-9474
(920) 209-0604
Mailing address
W2274 OUT OF TOWN LN, KAUKAUNA, WI 54130-9474
(920) 209-0604
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4647-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174831473
—
WI
Enumeration date
03/17/2015
Last updated
03/17/2015
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