| Pacific Nw Mindful Change Llc | |
|
304 Market St Se Unit E Roanoke VA 24011-2102 | |
| (540) 824-4461 | |
| (503) 400-7452 |
| Full Name | Pacific Nw Mindful Change Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 304 Market St Se Unit E, Roanoke, Virginia |
| Authorized Official Name and Position | Michelle Lee Retton (OWNER) |
| Authorized Official Contact | 5033298965 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Nw Mindful Change Llc 1234 Kerns Ave Sw Roanoke VA 24015-2537 Ph: (503) 329-8965 | Pacific Nw Mindful Change Llc 304 Market St Se Unit E Roanoke VA 24011-2102 Ph: (540) 824-4461 |
| NPI Number | 1437997145 |
|---|---|
| Provider Enumeration Date | 07/17/2024 |
| Last Update Date | 07/17/2024 |
| Certification Date | 07/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437997145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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