| Mindful Balance Psychological Wellness Llc | |
|
130 E Liberty St Plymouth MI 48170-1413 | |
| (734) 656-8611 | |
| Not Available |
| Full Name | Mindful Balance Psychological Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 130 E Liberty St, Plymouth, Michigan |
| Authorized Official Name and Position | Ryan Bidan (OWNER) |
| Authorized Official Contact | 2145359418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Balance Psychological Wellness Llc 208 High Canyon Ct Richardson TX 75080-2670 Ph: (214) 535-9418 | Mindful Balance Psychological Wellness Llc 130 E Liberty St Plymouth MI 48170-1413 Ph: (734) 656-8611 |
| NPI Number | 1316469174 |
|---|---|
| Provider Enumeration Date | 07/13/2017 |
| Last Update Date | 07/13/2017 |
| Medicare PECOS PAC ID | 6901214931 |
|---|---|
| Medicare Enrollment ID | O20210412002722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316469174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Suzanne Mariebel Hamil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588112593 PECOS PAC ID: 3870901762 Enrollment ID: I20210413002923 |
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