| Abundant Roots Therapy Llc | |
|
2224 Twenty Grand Ave Owensboro KY 42301-4935 | |
| (720) 428-1988 | |
| Not Available |
| Full Name | Abundant Roots Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2224 Twenty Grand Ave, Owensboro, Kentucky |
| Authorized Official Name and Position | Mary C Hansen (THERAPIST) |
| Authorized Official Contact | 7204281988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abundant Roots Therapy Llc 2224 Twenty Grand Ave Owensboro KY 42301-4935 Ph: (720) 428-1988 | Abundant Roots Therapy Llc 2224 Twenty Grand Ave Owensboro KY 42301-4935 Ph: (720) 428-1988 |
| NPI Number | 1114779220 |
|---|---|
| Provider Enumeration Date | 04/02/2024 |
| Last Update Date | 04/02/2024 |
| Certification Date | 04/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114779220 | NPI | - | NPPES |
| 1588228837 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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