Provider Demographics
NPI:1831900950
Name:RESILIENT MIND THERAPY AND NEUROFEEDBACK PLLC
Entity type:Organization
Organization Name:RESILIENT MIND THERAPY AND NEUROFEEDBACK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:LOUISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:319-214-0340
Mailing Address - Street 1:289 SUSSEX DR NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-1411
Mailing Address - Country:US
Mailing Address - Phone:319-214-0340
Mailing Address - Fax:
Practice Address - Street 1:700 16TH ST NE STE 201
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4665
Practice Address - Country:US
Practice Address - Phone:319-214-0340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty