Organization
MAGNOLIA MINDFULNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS SHORT LCSW (OWNER)
(314) 608-7305
Entity
Organization
Contact information
Practice address
3109 S GRAND BLVD STE 260H, SAINT LOUIS, MO 63118-1090
(314) 608-7305
Mailing address
3542 SIDNEY ST, SAINT LOUIS, MO 63104-1778
(314) 608-7305
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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