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General NPI Number Information
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NPI Number | 1710793997
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Entity Type | Organization
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Legal Business Name | THE VINES MENTAL HEALTH PRACTICE, PLLC
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 10300 N CENTRAL EXPY STE 280
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City | DALLAS
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State | TX
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Zip | 75231-8666
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Country | US
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Telephone | 214-444-9416
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Fax |
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Provider Business Mailing Address
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Address Line | 10300 N CENTRAL EXPY STE 280
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City | DALLAS
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State | TX
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Zip | 75231-8666
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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/THERAPIST
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Name | CARINA I RODRIGUEZ
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Credential |
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Telephone | 214-296-7306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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