Provider Demographics
NPI:1891520359
Name:NEUPATH MIND WELLNESS DELRAY BEACH, LLC
Entity type:Organization
Organization Name:NEUPATH MIND WELLNESS DELRAY BEACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:REANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMKHELAWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-281-2398
Mailing Address - Street 1:1874 DR ANDRES WAY STE 127
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4690
Mailing Address - Country:US
Mailing Address - Phone:561-847-3662
Mailing Address - Fax:
Practice Address - Street 1:1874 DR ANDRES WAY STE 127
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4690
Practice Address - Country:US
Practice Address - Phone:561-847-3662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty