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Organization

BODYMIND CONNECTIONS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BETH RACHAEL PARKER LCSW (PROVIDER)
(573) 442-5475
Entity
Organization

Contact information

Practice address
409 VANDIVER DR, BLDG 6 SUITE 104, COLUMBIA, MO 65202-3754
(573) 442-5475
(573) 442-5145
Mailing address
409 VANDIVER DR, BLDG 6 SUITE 104, COLUMBIA, MO 65202-3754
(573) 442-5475
(573) 442-5145

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002930
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
493553853
MO
Enumeration date
09/30/2008
Last updated
11/06/2008
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