| NPI | 1285570994 |
|---|---|
| Doing Business As | MIND & BODY RENEW MEDICAL SPA AND PSYCHIATRY |
| Entity Type | Organization |
| Authorized Contact | CHARISSE FULLWOOD CEO 910-713-8209 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251J00000X Nursing Care |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2026-04-25 |
| Last Update Date | 2026-04-25 |