| Haven Mind Body Collective, Llc | |
|
1105 15th Ave Ste F Longview WA 98632-3080 | |
| (360) 703-6499 | |
| Not Available |
| Full Name | Haven Mind Body Collective, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1105 15th Ave Ste F, Longview, Washington |
| Authorized Official Name and Position | Amanda Renee Hart (CERTIFIED COUNSELOR) |
| Authorized Official Contact | 3605625509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Haven Mind Body Collective, Llc 1105 15th Ave Ste F Longview WA 98632-3080 Ph: (360) 703-6499 | Haven Mind Body Collective, Llc 1105 15th Ave Ste F Longview WA 98632-3080 Ph: (360) 703-6499 |
| NPI Number | 1184477507 |
|---|---|
| Provider Enumeration Date | 04/08/2024 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184477507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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