Organization
INNOVATIVE MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA D. BUSH FNP-C, PMHNP-BC (NURSE PRACTITIONER/PROVIDER)
(314) 296-8933
Entity
Organization
Contact information
Practice address
12747 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141-6269
(314) 582-4398
Mailing address
1231 SHOREWINDS TRL, SAINT CHARLES, MO 63303-4833
(314) 296-8933
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/17/2020
Last updated
05/06/2020
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