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NPI 1790319127

NPI 1790319127 : BE YOUR BEST SELF PLLC : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1790319127
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    Entity Type          |    Organization 
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    Legal Business Name  |    BE YOUR BEST SELF PLLC 
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Dates
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    Enumeration Date     |    02/25/2020
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    Last Update Date     |    02/25/2020
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Provider Practice Location Address
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    Address Line         |    4514 COLE AVE STE 600 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75205-4193
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    Country              |    US
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    Telephone            |    214-444-9878
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    400 W PEMBROKE AVE 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75208-6534
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    Country              |    US
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    Telephone            |    214-444-9878
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    Fax                  |    
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Authorized Official
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    Title or Position    |    SOLE OWNER
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    Name                 |    MR. JONATHAN  MOSSBERG 
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    Credential           |    LCSW
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    Telephone            |    214-444-9878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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