| Untangled Minds Pllc | |
|
807 W Highway 50 Ste 3 O Fallon IL 62269-1856 | |
| (618) 468-8069 | |
| Not Available |
| Full Name | Untangled Minds Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 807 W Highway 50 Ste 3, O Fallon, Illinois |
| Authorized Official Name and Position | Audrey Gonzalez (OWNER) |
| Authorized Official Contact | 6184688069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Untangled Minds Pllc 807 W Highway 50 Ste 3 O Fallon IL 62269-1856 Ph: (618) 468-8069 | Untangled Minds Pllc 807 W Highway 50 Ste 3 O Fallon IL 62269-1856 Ph: (618) 468-8069 |
| NPI Number | 1952022527 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 06/04/2023 |
| Certification Date | 06/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952022527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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