| Soulwell Llc | |
|
201 S Hilgard St O Fallon IL 62269-2113 | |
| (618) 444-3894 | |
| Not Available |
| Full Name | Soulwell Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 201 S Hilgard St, O Fallon, Illinois |
| Authorized Official Name and Position | Jessica Gunther (OWNER) |
| Authorized Official Contact | 6184443894 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulwell Llc 201 S Hilgard St O Fallon IL 62269-2113 Ph: (618) 444-3894 | Soulwell Llc 201 S Hilgard St O Fallon IL 62269-2113 Ph: (618) 444-3894 |
| NPI Number | 1417597154 |
|---|---|
| Provider Enumeration Date | 01/10/2020 |
| Last Update Date | 01/10/2020 |
| Certification Date | 01/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417597154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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