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General NPI Number Information
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NPI Number | 1982519625
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Entity Type | Organization
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Legal Business Name | ALTERED PATHS WELLNESS, PLLC
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 2201 SPINKS RD STE 335
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City | FLOWER MOUND
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State | TX
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Zip | 75022
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Country | US
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Telephone | 682-354-8202
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Fax | 682-354-8202
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Provider Business Mailing Address
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Address Line | 5473 BLAIR RD SUITE 100
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City | DALLAS
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State | TX
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Zip | 75231-4227
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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 | EXECUTIVE DIRECTOR
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Name | AMANDA MANCHACK
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Credential | LCSW-S
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Telephone | 214-382-4730
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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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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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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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