| A Mix Of Emotions Llc | |
|
9015 Woodyard Rd Ste 206 Clinton MD 20735-4209 | |
| (240) 580-9956 | |
| Not Available |
| Full Name | A Mix Of Emotions Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9015 Woodyard Rd Ste 206, Clinton, Maryland |
| Authorized Official Name and Position | Miranda Mixon (OWNER/MENTAL HEALTH PROVIDER) |
| Authorized Official Contact | 2405809956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Mix Of Emotions Llc 9015 Woodyard Rd Ste 206 Clinton MD 20735-4209 Ph: (240) 580-9956 | A Mix Of Emotions Llc 9015 Woodyard Rd Ste 206 Clinton MD 20735-4209 Ph: (240) 580-9956 |
| NPI Number | 1235968371 |
|---|---|
| Provider Enumeration Date | 07/29/2024 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 7618416223 |
|---|---|
| Medicare Enrollment ID | O20240827004264 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235968371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Miranda Mixon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861956419 PECOS PAC ID: 8527507136 Enrollment ID: I20240905000794 |
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