| Genuine Life Wellness Pllc | |
|
8340 Meadow Rd Ste 224 Dallas TX 75231-0326 | |
| (972) 742-2186 | |
| (469) 232-9943 |
| Full Name | Genuine Life Wellness Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 8340 Meadow Rd Ste 224, Dallas, Texas |
| Authorized Official Name and Position | Jennifer S Hartman (SINGLE MEMBER, LICENSED PSYCHOLOGIS) |
| Authorized Official Contact | 9727422186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genuine Life Wellness Pllc 8340 Meadow Rd Ste 224 Dallas TX 75231-0326 Ph: (972) 742-2186 | Genuine Life Wellness Pllc 8340 Meadow Rd Ste 224 Dallas TX 75231-0326 Ph: (972) 742-2186 |
| NPI Number | 1851714166 |
|---|---|
| Provider Enumeration Date | 01/23/2014 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Medicare PECOS PAC ID | 2961626577 |
|---|---|
| Medicare Enrollment ID | O20140620000660 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851714166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 32123 (Texas) | Primary |
| Provider Name | Jennifer S Hartman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114947199 PECOS PAC ID: 0941499693 Enrollment ID: I20110111000461 |
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