Organization
MINDFUL PSYCHOLOGY AND WELLNESS CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA DAVENPORT PH.D. (PRESIDENT)
(786) 383-1856
Entity
Organization
Contact information
Practice address
1931 NW 150TH AVE STE 116, PEMBROKE PINES, FL 33028-2873
(786) 383-1856
(786) 431-4872
Mailing address
1931 NW 150TH AVE STE 116, PEMBROKE PINES, FL 33028-2873
(786) 383-1856
(431) 487-2786
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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