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Organization

ELEVATE MENTAL HEALTH CONSULTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIVIAN KISANGA PMHNP (OWNER)
(817) 657-5107
Entity
Organization

Contact information

Practice address
1021 LILAC LN, DESOTO, TX 75115-1496
(817) 657-5107
Mailing address
1021 LILAC LN, DESOTO, TX 75115-1496

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
02/14/2018
Last updated
02/14/2018
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