| Mohave Neurofeedback Clinic, Llc | |
|
405 E Beale St Kingman AZ 86401-5833 | |
| (928) 263-1045 | |
| (928) 597-5172 |
| Full Name | Mohave Neurofeedback Clinic, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 405 E Beale St, Kingman, Arizona |
| Authorized Official Name and Position | Audra Nicole Jalbert (OWNER, COUNSELOR) |
| Authorized Official Contact | 9282631045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohave Neurofeedback Clinic, Llc 1570 E Northern Ave Ste C Kingman AZ 86409-2483 Ph: (928) 263-1045 | Mohave Neurofeedback Clinic, Llc 405 E Beale St Kingman AZ 86401-5833 Ph: (928) 263-1045 |
| NPI Number | 1174249015 |
|---|---|
| Provider Enumeration Date | 10/12/2022 |
| Last Update Date | 10/12/2022 |
| Certification Date | 09/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174249015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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