Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Adolescent and Children Mental Health |
261QM0855X |
| NPI # | 1912688193 |
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| LBN Legal business name | THE MINDWELL CENTER, LLC | ||||
| Authorized official | DEVON SUOZZI - (FOUNDER/SUPERVISING PSYCHOTHERAPIST) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 07/31/2023 | ||||
| Last updated | 07/31/2023 - About 3 years ago | ||||
| Identifiers |
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