| My Restored Balance Llc | |
|
202 N Division St Bonne Terre MO 63628-1228 | |
| (573) 604-4167 | |
| (866) 811-7475 |
| Full Name | My Restored Balance Llc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 202 N Division St, Bonne Terre, Missouri |
| Authorized Official Name and Position | Mary Dahmm (OWNER) |
| Authorized Official Contact | 3147667065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Restored Balance Llc 202 N Division St Bonne Terre MO 63628-1228 Ph: (573) 604-4167 | My Restored Balance Llc 202 N Division St Bonne Terre MO 63628-1228 Ph: (573) 604-4167 |
| NPI Number | 1154156776 |
|---|---|
| Provider Enumeration Date | 09/04/2024 |
| Last Update Date | 09/16/2024 |
| Certification Date | 09/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154156776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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