| Mental Wellness Club Llc | |
|
510 S Fairmont Ave Suite 2 Lodi CA 95240 | |
| (209) 471-3856 | |
| (209) 644-7606 |
| Full Name | Mental Wellness Club Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 510 S Fairmont Ave Suite 2, Lodi, California |
| Authorized Official Name and Position | Awnee Mitchell (OWNER) |
| Authorized Official Contact | 2094713856 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Wellness Club Llc 7627 River Otter Way Elk Grove CA 95758 Ph: (209) 471-3856 | Mental Wellness Club Llc 510 S Fairmont Ave Suite 2 Lodi CA 95240 Ph: (209) 471-3856 |
| NPI Number | 1184305898 |
|---|---|
| Provider Enumeration Date | 07/26/2023 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184305898 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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