Organization
MIND OVER MOOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JAMIE KAKKANATTU CRNP (OWNER)
(610) 978-6677
Entity
Organization
Contact information
Practice address
10 BERKLEY RD, BROOMALL, PA 19008-2413
(610) 978-6677
(610) 672-4753
Mailing address
10 BERKLEY RD, BROOMALL, PA 19008-2413
(610) 978-6677
(610) 672-4753
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
12/19/2023
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