Provider Demographics
NPI:1851099949
Name:RARE MIND AND BODY
Entity Type:Organization
Organization Name:RARE MIND AND BODY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:IMAGINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:586-943-9306
Mailing Address - Street 1:28111 JEFFERSON AVE APT E6
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2523
Mailing Address - Country:US
Mailing Address - Phone:586-675-8424
Mailing Address - Fax:
Practice Address - Street 1:28111 JEFFERSON AVE APT E6
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2523
Practice Address - Country:US
Practice Address - Phone:586-675-8424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty