| Magnolia Therapy Services, Llc | |
|
205 N Conception St Mobile AL 36603-6477 | |
| (251) 320-5875 | |
| (251) 459-0065 |
| Full Name | Magnolia Therapy Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 205 N Conception St, Mobile, Alabama |
| Authorized Official Name and Position | Laura O Gale (OWNER/PRESIDENT) |
| Authorized Official Contact | 2516053985 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Therapy Services, Llc 205 N Conception St Mobile AL 36603-6477 Ph: (251) 320-5875 | Magnolia Therapy Services, Llc 205 N Conception St Mobile AL 36603-6477 Ph: (251) 320-5875 |
| NPI Number | 1598412637 |
|---|---|
| Provider Enumeration Date | 03/08/2022 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Medicare PECOS PAC ID | 3476931536 |
|---|---|
| Medicare Enrollment ID | O20220601001248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598412637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Laura O Gale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235794561 PECOS PAC ID: 4486984473 Enrollment ID: I20190917003440 |
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