Organization
WITH MOM IN MIND,LLC
Active
Organization
WITH MOM IN MIND,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MARIE CARTER NDTR,CDM,CFPP, CPT (REGISTERED DIETETIC TECHNICIAN)
(313) 492-8446
Entity
Organization
Contact information
Practice address
18501 WEST MILE ROAD, SOUTHFIELD, MI 48075
(313) 492-8446
(248) 200-7968
Mailing address
18501 WEST MILE ROAD, SOUTHFIELD, MI 48075
(313) 492-8446
(248) 200-7968
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
261QA0005X
Ambulatory Family Planning Facility
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP0904X
Federal Public Health Clinic/Center
Primary
—
—
261QP0905X
State or Local Public Health Clinic/Center
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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