Provider Demographics
NPI:1770837759
Name:PAMPER YOUR MIND, LLC
Entity Type:Organization
Organization Name:PAMPER YOUR MIND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODLING
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:321-543-2087
Mailing Address - Street 1:2020 HWY A1A
Mailing Address - Street 2:SUITE 104
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3581
Mailing Address - Country:US
Mailing Address - Phone:321-543-2087
Mailing Address - Fax:
Practice Address - Street 1:2020 HWY A1A
Practice Address - Street 2:SUITE 104
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3581
Practice Address - Country:US
Practice Address - Phone:321-543-2087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty