Provider Demographics
NPI:1518663129
Name:BLISSFUL ESSENCE MIND & BODY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:BLISSFUL ESSENCE MIND & BODY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALANDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP, PMHNP
Authorized Official - Phone:210-302-5505
Mailing Address - Street 1:229 WEXFORD
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-4505
Mailing Address - Country:US
Mailing Address - Phone:210-302-5505
Mailing Address - Fax:
Practice Address - Street 1:229 WEXFORD
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-4505
Practice Address - Country:US
Practice Address - Phone:210-302-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty