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General NPI Number Information
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NPI Number | 1548113178
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Entity Type | Organization
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Legal Business Name | VANILLE MIND PATHWAY THERAPY
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Dates
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Enumeration Date | 02/14/2026
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Last Update Date | 02/14/2026
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Provider Practice Location Address
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Address Line | 3312 RIVERVIEW DR
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City | MESQUITE
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State | TX
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Zip | 75181-1666
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Country | US
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Telephone | 214-377-8519
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Fax |
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Provider Business Mailing Address
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Address Line | 805 WILMINGTON LN
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City | AUBREY
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State | TX
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Zip | 76227-1584
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ISAH YUSUF
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Credential |
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Telephone | 469-739-3941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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