| Ruby Waves Of Wellness, Pllc | |
|
105 W Prairie Ave Ogden IL 61859-8808 | |
| (765) 761-3997 | |
| (217) 670-6712 |
| Full Name | Ruby Waves Of Wellness, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 105 W Prairie Ave, Ogden, Illinois |
| Authorized Official Name and Position | Josie D Mitchell (OWNER/CLINICIAN) |
| Authorized Official Contact | 7657613997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ruby Waves Of Wellness, Pllc Po Box 374 Ogden IL 61859-0374 Ph: (765) 761-3997 | Ruby Waves Of Wellness, Pllc 105 W Prairie Ave Ogden IL 61859-8808 Ph: (765) 761-3997 |
| NPI Number | 1407626385 |
|---|---|
| Provider Enumeration Date | 01/03/2024 |
| Last Update Date | 02/23/2024 |
| Certification Date | 02/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407626385 | NPI | - | NPPES |
| 1740650530 | Other | IL | NPI 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Josie D Mitchell Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 W Prairie Ave, Ogden, IL 61859 Phone: 217-274-2363 |