| NPI | 1871264051 |
|---|---|
| Former Legal Business Name | EMPOWERED MIND & BODY LLC |
| Entity Type | Organization |
| Authorized Contact | JENNA BAUER Licensed Clinical Psychologist 872-208-8833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-09-27 |