| Mind Body Mirror Llc | |
|
9000 Quantrelle Ave Ne Otsego MN 55330-1022 | |
| (219) 595-2121 | |
| Not Available |
| Full Name | Mind Body Mirror Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 9000 Quantrelle Ave Ne, Otsego, Minnesota |
| Authorized Official Name and Position | Rebecca Michelle Anderson (OWNER) |
| Authorized Official Contact | 2195952121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Body Mirror Llc 8808 373rd Ave Nw Princeton MN 55371-5512 Ph: (651) 210-4020 | Mind Body Mirror Llc 9000 Quantrelle Ave Ne Otsego MN 55330-1022 Ph: (219) 595-2121 |
| NPI Number | 1922897917 |
|---|---|
| Provider Enumeration Date | 05/05/2025 |
| Last Update Date | 05/05/2025 |
| Certification Date | 05/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922897917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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