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General NPI Number Information
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NPI Number | 1295306355
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Entity Type | Organization
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Legal Business Name | MINDFUL BEHAVIORAL SOLUTIONS LLC
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 8035 E R L THORNTON FWY STE 334
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City | DALLAS
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State | TX
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Zip | 75228-7018
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Country | US
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Telephone | 888-550-4842
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Fax | 888-550-3391
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Provider Business Mailing Address
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Address Line | 8811 TEEL PKWY STE 100-5476
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City | FRISCO
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State | TX
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Zip | 75035-4201
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Country | US
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Telephone | 888-550-4842
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Fax | 888-550-3391
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | FAITH I OGALA
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Credential | MSN, PMHNP-BC
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Telephone | 888-550-4842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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