Organization
MUSTARD SEED CENTER FOR GROWTH LLC
Active
Parent organization
-
Other names
Mini Minds
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
KRISTIN KOUKA (OWNER)
(317) 460-2384
Entity
Organization
Contact information
Practice address
580 E CARMEL DR STE 302, CARMEL, IN 46032-3317
(317) 660-5737
Mailing address
580 E CARMEL DR STE 302, CARMEL, IN 46032-3317
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
163W00000X
Registered Nurse
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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