| Untangled Roots Llc | |
|
43 Hanson Dr Bourbonnais IL 60914-1105 | |
| (779) 379-9575 | |
| Not Available |
| Full Name | Untangled Roots Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 43 Hanson Dr, Bourbonnais, Illinois |
| Authorized Official Name and Position | Megan Pfeifer (OWNER) |
| Authorized Official Contact | 7019365598 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Untangled Roots Llc 43 Hanson Dr Bourbonnais IL 60914-1105 Ph: () - | Untangled Roots Llc 43 Hanson Dr Bourbonnais IL 60914-1105 Ph: (779) 379-9575 |
| NPI Number | 1659009801 |
|---|---|
| Provider Enumeration Date | 08/15/2022 |
| Last Update Date | 08/15/2022 |
| Certification Date | 08/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659009801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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