| Phenomenal U Pllc | |
|
1071 Lake Carolyn Pkwy Apt 3089 Irving TX 75039-4868 | |
| (469) 830-2848 | |
| Not Available |
| Full Name | Phenomenal U Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1071 Lake Carolyn Pkwy Apt 3089, Irving, Texas |
| Authorized Official Name and Position | Skye Alexia Glover (OWNER, THERAPIST) |
| Authorized Official Contact | 4698302848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phenomenal U Pllc 1071 Lake Carolyn Pkwy Apt 3089 Irving TX 75039-4868 Ph: (469) 830-2848 | Phenomenal U Pllc 1071 Lake Carolyn Pkwy Apt 3089 Irving TX 75039-4868 Ph: (469) 830-2848 |
| NPI Number | 1902582133 |
|---|---|
| Provider Enumeration Date | 06/22/2023 |
| Last Update Date | 06/22/2023 |
| Certification Date | 06/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902582133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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