Provider Demographics
NPI:1093468530
Name:THE MIND AND BODY MOVEMENT
Entity Type:Organization
Organization Name:THE MIND AND BODY MOVEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, YOGA THERAPIST, COACH
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-202-9046
Mailing Address - Street 1:1893 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-1674
Mailing Address - Country:US
Mailing Address - Phone:908-202-9046
Mailing Address - Fax:732-884-6057
Practice Address - Street 1:125 FRONT ST
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-3401
Practice Address - Country:US
Practice Address - Phone:908-202-9046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Multi-Specialty