Organization
ARDENT PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROZEMARIJN STAAL PSYD (OWNER/PSYCHOLOGIST)
(682) 477-8884
Entity
Organization
Contact information
Practice address
180 STATE ST, SOUTHLAKE, TX 76092-7620
(682) 477-8884
Mailing address
2736 STADIUM VIEW DR, FORT WORTH, TX 76118-2031
(513) 316-3004
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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