Organization
BODY MIND SOUL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A JORGENSON LMSW (OWNER/THERAPIST)
(269) 615-8639
Entity
Organization
Contact information
Practice address
5985 WEST MAIN STREET, 814, KALAMAZOO, MI 49009
(269) 615-8639
Mailing address
P.O. BOX 20056, KALAMAZOO, MI 49019
(269) 615-8639
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1538351150
MI
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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