| Transformed Minds, Pllc | |
|
2640 Clayburne Dr Jonesboro AR 72405-8160 | |
| (972) 213-6682 | |
| Not Available |
| Full Name | Transformed Minds, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2640 Clayburne Dr, Jonesboro, Arkansas |
| Authorized Official Name and Position | Tyler Latele Jackson (OWNER) |
| Authorized Official Contact | 9722136682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformed Minds, Pllc 2640 Clayburne Dr Jonesboro AR 72405-8160 Ph: (972) 213-6682 | Transformed Minds, Pllc 2640 Clayburne Dr Jonesboro AR 72405-8160 Ph: (972) 213-6682 |
| NPI Number | 1003631631 |
|---|---|
| Provider Enumeration Date | 11/19/2024 |
| Last Update Date | 11/19/2024 |
| Certification Date | 11/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003631631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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