Provider Demographics
NPI:1497451694
Name:FREEDOM MIND PLLC
Entity Type:Organization
Organization Name:FREEDOM MIND PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MAIMOUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIOP
Authorized Official - Suffix:
Authorized Official - Credentials:DNP-MSN-APRN-BC
Authorized Official - Phone:919-434-4552
Mailing Address - Street 1:2500 REGENCY PKWY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8549
Mailing Address - Country:US
Mailing Address - Phone:919-751-6327
Mailing Address - Fax:
Practice Address - Street 1:2500 REGENCY PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8549
Practice Address - Country:US
Practice Address - Phone:919-751-6327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty