Provider Demographics
NPI:1730811662
Name:MIND BODY CENTER, PLLC
Entity type:Organization
Organization Name:MIND BODY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNKLE-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-854-4887
Mailing Address - Street 1:1720 WASHINGTON RD STE 208
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1208
Mailing Address - Country:US
Mailing Address - Phone:412-854-4887
Mailing Address - Fax:412-386-3733
Practice Address - Street 1:1720 WASHINGTON RD STE 208
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1208
Practice Address - Country:US
Practice Address - Phone:412-854-4887
Practice Address - Fax:412-386-3733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty