Imynd Connects, Llc | |
745 Craig Rd Ste 104 Creve Coeur MO 63141-7122 | |
(314) 606-1265 | |
Not Available |
Full Name | Imynd Connects, Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 745 Craig Rd Ste 104, Creve Coeur, Missouri |
Authorized Official Name and Position | Susan Elizabeth Stevenson Moore (OWNER) |
Authorized Official Contact | 3146061265 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Imynd Connects, Llc 745 Craig Rd Ste 104 Creve Coeur MO 63141-7122 Ph: (314) 606-1265 | Imynd Connects, Llc 745 Craig Rd Ste 104 Creve Coeur MO 63141-7122 Ph: (314) 606-1265 |
NPI Number | 1104446194 |
---|---|
Provider Enumeration Date | 04/20/2020 |
Last Update Date | 05/11/2020 |
Certification Date | 05/11/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104446194 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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