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Organization

MINDFUL PATH BEHAVIORAL HEALTH AND WELLNESS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JABRIEL ROSE PSY.D. (PRESIDENT AND TREASURER)
(847) 224-5282
Entity
Organization

Contact information

Practice address
53 W JACKSON BLVD, SUITE 1111, CHICAGO, IL 60604-3606
(847) 224-5282
Mailing address
53 W JACKSON BLVD, SUITE 1111, CHICAGO, IL 60604-3606
(847) 224-5282

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.007542
IL

Other

Enumeration date
12/27/2012
Last updated
12/27/2012
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