| 2btraumafree Llc | |
|
17 E Saint Joseph St Perryville MO 63775-2016 | |
| (573) 510-9488 | |
| Not Available |
| Full Name | 2btraumafree Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 17 E Saint Joseph St, Perryville, Missouri |
| Authorized Official Name and Position | Annie Mouser (CREDENTIALING) |
| Authorized Official Contact | 9037166602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 2btraumafree Llc 20 S West St Perryville MO 63775-2547 Ph: () - | 2btraumafree Llc 17 E Saint Joseph St Perryville MO 63775-2016 Ph: (573) 510-9488 |
| NPI Number | 1720858657 |
|---|---|
| Provider Enumeration Date | 01/02/2024 |
| Last Update Date | 01/23/2024 |
| Certification Date | 01/23/2024 |
| Medicare PECOS PAC ID | 8224473996 |
|---|---|
| Medicare Enrollment ID | O20240304003193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720858657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mary P Esswein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598871709 PECOS PAC ID: 6901900646 Enrollment ID: I20070405000094 |
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