| NPI | 1003493610 |
|---|---|
| Former Legal Business Name | MODERN MIND THERAPY & LIFE COACHING LLC |
| Entity Type | Organization |
| Authorized Contact | LAKEISHA GRAYER Owner 757-303-7808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2021-04-05 |