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General NPI Number Information
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NPI Number | 1649739236
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Entity Type | Organization
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Legal Business Name | INNOVATIVE PSYCH SOLUTIONS
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 1402 S CUSTER RD STE 202
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City | MCKINNEY
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State | TX
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Zip | 75072-1452
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Country | US
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Telephone | 214-842-8463
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Fax | 469-535-8756
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Provider Business Mailing Address
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Address Line | 619 QUAIL RUN DR
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City | MURPHY
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State | TX
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Zip | 75094-3853
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Country | US
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Telephone | 817-917-3821
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Fax |
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Authorized Official
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Title or Position | PMHNP, APRN (CO-OWNER)
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Name | SONIA THOMAS PILLAI
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Credential | APRN
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Telephone | 817-917-3821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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