| NPI | 1710579826 |
|---|---|
| Doing Business As | WAVEMIND CLINIC |
| Former Legal Business Name | MINDBLOOM INC, A PSYCHOLOGY CORPORATION |
| Entity Type | Organization |
| Authorized Contact | DANIELLE CORNACCHIO Licensed Psychologist, Owner 914-275-5578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2023-05-19 |