| Inner Wisdom Yoga And Psychotherapy, Pllc | |
|
1420 3rd St Sw Roanoke VA 24016-5205 | |
| (540) 798-8478 | |
| Not Available |
| Full Name | Inner Wisdom Yoga And Psychotherapy, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1420 3rd St Sw, Roanoke, Virginia |
| Authorized Official Name and Position | Annemarie Carroll (OWNER) |
| Authorized Official Contact | 5407988478 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Wisdom Yoga And Psychotherapy, Pllc 2921 Oak Crest Ave Sw Roanoke VA 24015-4609 Ph: (540) 798-8478 | Inner Wisdom Yoga And Psychotherapy, Pllc 1420 3rd St Sw Roanoke VA 24016-5205 Ph: (540) 798-8478 |
| NPI Number | 1265055321 |
|---|---|
| Provider Enumeration Date | 05/24/2020 |
| Last Update Date | 05/24/2020 |
| Certification Date | 05/24/2020 |
| Medicare PECOS PAC ID | 9436577111 |
|---|---|
| Medicare Enrollment ID | O20200911001560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265055321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Annemarie Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538667175 PECOS PAC ID: 0840264982 Enrollment ID: I20200911001662 |
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