Provider Demographics
NPI:1063821445
Name:MINDFULKIDS SERVICES
Entity Type:Organization
Organization Name:MINDFULKIDS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:EMILY
Authorized Official - Last Name:GORIGOITIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-703-9853
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-0277
Mailing Address - Country:US
Mailing Address - Phone:610-703-9853
Mailing Address - Fax:
Practice Address - Street 1:2700 N CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9735
Practice Address - Country:US
Practice Address - Phone:610-703-9853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty