NPI | 1710579826 |
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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 |