NPI | 1114502929 |
---|---|
Doing Business As | MODERN MIND THERAPY |
Entity Type | Organization |
Authorized Contact | JESSICA AYALA Therapist/ Owner 973-930-9749 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2021-03-12 |
Last Update Date | 2021-03-12 |