Organization
MANDALA FAMILY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE FALWELL PH.D (CEO)
(904) 521-6266
Entity
Organization
Contact information
Practice address
171 CANAL BLVD, PONTE VEDRA BEACH, FL 32082-3607
(904) 608-0782
Mailing address
171 CANAL BLVD, PONTE VEDRA BEACH, FL 32082-3607
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY7735
FL
Other
Enumeration date
01/09/2018
Last updated
10/05/2023
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