| Mind & Mane Pllc | |
|
3664 Genesis Ln Wake Forest NC 27587-6088 | |
| (443) 538-7275 | |
| Not Available |
| Full Name | Mind & Mane Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3664 Genesis Ln, Wake Forest, North Carolina |
| Authorized Official Name and Position | Nicole Tai (CEO) |
| Authorized Official Contact | 4435387275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind & Mane Pllc 3664 Genesis Ln Wake Forest NC 27587-6088 Ph: (443) 538-7275 | Mind & Mane Pllc 3664 Genesis Ln Wake Forest NC 27587-6088 Ph: (443) 538-7275 |
| NPI Number | 1023682325 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Certification Date | 05/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023682325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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