Organization
A CHANGE OF MIND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEIDI ANN WILSON LCSW (OWNER)
(239) 260-4387
Entity
Organization
Contact information
Practice address
5020 TAMIAMI TRAIL N, SUITE 202, NAPLES, FL 34103
(239) 260-4387
(844) 715-9627
Mailing address
5020 TAMIAMI TRAIL N, SUITE 202, NAPLES, FL 34103
(239) 260-4387
(844) 715-9627
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW9293
FL
251S00000X
Community/Behavioral Health Agency
SW9293
FL
Other
Enumeration date
02/03/2017
Last updated
01/04/2018
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