Untangled Minds Pllc | |
807 W Highway 50 Ste 3 O Fallon IL 62269-1856 | |
(618) 468-8069 | |
Not Available |
Full Name | Untangled Minds Pllc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 807 W Highway 50 Ste 3, O Fallon, Illinois |
Authorized Official Name and Position | Audrey Gonzalez (OWNER) |
Authorized Official Contact | 6184688069 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Untangled Minds Pllc 807 W Highway 50 Ste 3 O Fallon IL 62269-1856 Ph: (618) 468-8069 | Untangled Minds Pllc 807 W Highway 50 Ste 3 O Fallon IL 62269-1856 Ph: (618) 468-8069 |
NPI Number | 1952022527 |
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Provider Enumeration Date | 09/12/2022 |
Last Update Date | 06/04/2023 |
Certification Date | 06/04/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952022527 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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