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Organization

MIND-BODY AND INNER SELF

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ANGELA NICOLE BLAND M.S. (THERAPIST)
(917) 658-9767
Entity
Organization

Contact information

Practice address
11929 80TH RD, SUITE A, KEW GARDENS, NY 11415-1105
(718) 362-0615
Mailing address
11929 80TH RD, SUITE A, KEW GARDENS, NY 11415-1105
(718) 362-0615

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary

Other

Enumeration date
11/25/2008
Last updated
11/25/2008
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