Provider Demographics
NPI:1821897018
Name:NUTRITION OF MIND THERAPY & WELLNESS
Entity type:Organization
Organization Name:NUTRITION OF MIND THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KORIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YASHAR
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, RDN
Authorized Official - Phone:954-887-6588
Mailing Address - Street 1:2699 STIRLING RD STE C404
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6595
Mailing Address - Country:US
Mailing Address - Phone:954-887-6588
Mailing Address - Fax:
Practice Address - Street 1:2699 STIRLING RD STE C404
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6595
Practice Address - Country:US
Practice Address - Phone:954-887-6588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty