Organization
MIND OVER MATTER MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRAINE JEANETTE DIRICCO ARNP, RN (OWNER)
(509) 934-1925
Entity
Organization
Contact information
Practice address
1717 W FRANCIS AVE STE 204, SPOKANE, WA 99205-6858
(509) 934-1925
(509) 868-0874
Mailing address
1717 W FRANCIS AVE STE 204, SPOKANE, WA 99205-6858
(509) 934-1925
(509) 868-0874
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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