| Mindful Mountain Wellness Center | |
|
2014 Memorial Ave Sw Roanoke VA 24015-2032 | |
| (540) 750-4996 | |
| Not Available |
| Full Name | Mindful Mountain Wellness Center |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 2014 Memorial Ave Sw, Roanoke, Virginia |
| Authorized Official Name and Position | Ryan Matthew White (PSYCHIATRIST) |
| Authorized Official Contact | 2103155629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Mountain Wellness Center 4734 Hickory Hill Dr Roanoke VA 24018-7430 Ph: (210) 315-5629 | Mindful Mountain Wellness Center 2014 Memorial Ave Sw Roanoke VA 24015-2032 Ph: (540) 750-4996 |
| NPI Number | 1083453161 |
|---|---|
| Provider Enumeration Date | 05/20/2024 |
| Last Update Date | 07/15/2024 |
| Certification Date | 07/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083453161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
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