Organization
AZUL MINDSPACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE RENEE WHITE MA (PSYCHOLOGIST / OWNER)
(786) 505-4022
Entity
Organization
Contact information
Practice address
10631 HABITAT TRL, BOKEELIA, FL 33922-3122
(786) 505-4022
Mailing address
10631 HABITAT TRL, BOKEELIA, FL 33922-3122
(786) 505-4022
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/19/2023
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