| Mindsprouts Personal Growth Therapy Pllc | |
|
16135 Preston Rd Ste 116 Dallas TX 75248-8532 | |
| (214) 830-9879 | |
| Not Available |
| Full Name | Mindsprouts Personal Growth Therapy Pllc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 16135 Preston Rd Ste 116, Dallas, Texas |
| Authorized Official Name and Position | Connie M Siciliano Avila (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 2148309879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindsprouts Personal Growth Therapy Pllc Po Box 863842 Plano TX 75086-3842 Ph: (214) 830-9879 | Mindsprouts Personal Growth Therapy Pllc 16135 Preston Rd Ste 116 Dallas TX 75248-8532 Ph: (214) 830-9879 |
| NPI Number | 1730635053 |
|---|---|
| Provider Enumeration Date | 08/28/2016 |
| Last Update Date | 03/01/2021 |
| Certification Date | 03/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730635053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 63226 (Texas) | Secondary |
| 103TC1900X | Psychologist - Counseling | 37241 (Texas) | Primary |
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