Provider Demographics
NPI:1295602944
Name:MINDFUL BALANCE EMOTIONAL HEALTH
Entity type:Organization
Organization Name:MINDFUL BALANCE EMOTIONAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-887-3304
Mailing Address - Street 1:8084 WATSON RD STE 245
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-5326
Mailing Address - Country:US
Mailing Address - Phone:314-887-3304
Mailing Address - Fax:314-207-2263
Practice Address - Street 1:8084 WATSON RD STE 245
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5326
Practice Address - Country:US
Practice Address - Phone:314-887-3304
Practice Address - Fax:314-207-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-18
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)