Provider Demographics
NPI:1275292237
Name:BODY MIND THERAPY INC
Entity Type:Organization
Organization Name:BODY MIND THERAPY INC
Other - Org Name:BODY MIND THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YASUKO
Authorized Official - Middle Name:
Authorized Official - Last Name:AKIYAMA-BEVETT
Authorized Official - Suffix:
Authorized Official - Credentials:MHC
Authorized Official - Phone:808-457-2669
Mailing Address - Street 1:1314 S KING ST STE 1552
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1949
Mailing Address - Country:US
Mailing Address - Phone:808-457-2669
Mailing Address - Fax:808-689-8244
Practice Address - Street 1:1314 S KING ST STE 1552
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1949
Practice Address - Country:US
Practice Address - Phone:808-457-2669
Practice Address - Fax:808-689-8244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)