| Ardent Psychological Services, Pllc | |
|
180 State St Southlake TX 76092-7620 | |
| (682) 477-8884 | |
| Not Available |
| Full Name | Ardent Psychological Services, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 180 State St, Southlake, Texas |
| Authorized Official Name and Position | Rozemarijn Staal (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 6824778884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ardent Psychological Services, Pllc 2736 Stadium View Dr Fort Worth TX 76118-2031 Ph: (513) 316-3004 | Ardent Psychological Services, Pllc 180 State St Southlake TX 76092-7620 Ph: (682) 477-8884 |
| NPI Number | 1154038578 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 11/04/2022 |
| Certification Date | 11/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154038578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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