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General NPI Number Information
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NPI Number | 1700483468
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Entity Type | Organization
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Legal Business Name | KND BEHAVIORAL HEALTH CLINIC PLLC
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Dates
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Enumeration Date | 10/06/2020
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 99 REGENCY PKWY STE 113
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City | MANSFIELD
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State | TX
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Zip | 76063-7818
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Country | US
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Telephone | 972-904-5760
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Fax | 817-592-3323
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Provider Business Mailing Address
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Address Line | 99 REGENCY PKWY STE 113
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City | MANSFIELD
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State | TX
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Zip | 76063-7818
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Country | US
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Telephone | 972-904-5760
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Fax | 817-592-3323
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY ONWUBUYA
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Credential | PMHNP
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Telephone | 661-472-4897
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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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