Organization
MAIN STREET MENTAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA EDWARDS PMHNP (OWNER/AUTHORIZED OFFICIAL)
(641) 442-6615
Entity
Organization
Contact information
Practice address
307 E MAIN ST, GARDEN GROVE, IA 50103-1025
(641) 442-6615
Mailing address
307 E MAIN ST, GARDEN GROVE, IA 50103-1025
(641) 442-6615
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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