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 |