Healthcare Provider Details

I. General information

NPI: 1255813143
Provider Name (Legal Business Name): NEUROSKILLS INTEGRATED LEARNING AND CONSULTING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N WATSON RD STE 228
ARLINGTON TX
76006-6248
US

IV. Provider business mailing address

1201 N WATSON RD STE 228
ARLINGTON TX
76006-6248
US

V. Phone/Fax

Practice location:
  • Phone: 682-321-7004
  • Fax:
Mailing address:
  • Phone: 682-321-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. MATHIAS NGWA
Title or Position: PSYD
Credential:
Phone: 682-321-7004