Healthcare Provider Details

I. General information

NPI: 1619705233
Provider Name (Legal Business Name): OHLENFORST THERAPY DALLAS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12800 HILLCREST RD # A124
DALLAS TX
75230-1524
US

IV. Provider business mailing address

12800 HILLCREST RD # A124
DALLAS TX
75230-1524
US

V. Phone/Fax

Practice location:
  • Phone: 214-755-6119
  • Fax:
Mailing address:
  • Phone: 214-755-6119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTEN OHLENFORST
Title or Position: OWNER/MANAGER
Credential: PHD
Phone: 214-755-6119