| NPI | 1194402503 |
|---|---|
| Doing Business As | MIND MEDICINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | REBECCAH S LYLES Owner/Provider 312-882-0432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2024-02-16 |