| Carnelian Llc | |
|
7827 Town Square Ave # 104-1092 O Fallon MO 63368-7197 | |
| (314) 200-5113 | |
| (314) 552-7539 |
| Full Name | Carnelian Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7827 Town Square Ave # 104-1092, O Fallon, Missouri |
| Authorized Official Name and Position | Nicole Landwehr (OWNER) |
| Authorized Official Contact | 3143243835 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carnelian Llc 7827 Town Square Ave # 104-1092 O Fallon MO 63368-7197 Ph: (314) 200-5113 | Carnelian Llc 7827 Town Square Ave # 104-1092 O Fallon MO 63368-7197 Ph: (314) 200-5113 |
| NPI Number | 1053069989 |
|---|---|
| Provider Enumeration Date | 03/10/2022 |
| Last Update Date | 09/27/2022 |
| Certification Date | 09/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053069989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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