Provider Demographics
NPI:1750266193
Name:MINDFUL MOVES SPEECH-LANGUAGE PATHOLOGIST
Entity type:Organization
Organization Name:MINDFUL MOVES SPEECH-LANGUAGE PATHOLOGIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO/COO
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:HARNISH
Authorized Official - Last Name:ALJILANI
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:619-254-1002
Mailing Address - Street 1:10635 LOIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131
Mailing Address - Country:US
Mailing Address - Phone:619-254-1002
Mailing Address - Fax:858-224-8239
Practice Address - Street 1:10635 LOIRE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131
Practice Address - Country:US
Practice Address - Phone:619-254-1002
Practice Address - Fax:858-224-8239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty