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Organization

MIND BODY THERAPY, LLC

Active
Other names
Pamela Tinoco-Carreon, Pamela Beranek
Organization subpart
No

Provider details

NPI number
Authorized official
NIKKI M DENNIS (CREDENTIALING AGENT)
(316) 308-8273
Entity
Organization

Contact information

Practice address
123 N TYLER RD STE 300, WICHITA, KS 67212-3726
(316) 869-2230
Mailing address
123 N TYLER RD STE 300, WICHITA, KS 67212-3726
(316) 869-2230

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
03/08/2021
Last updated
03/16/2021
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