Organization
MIND SPA INC
Active
Organization
MIND SPA INC
Active
Other names
Solution Health and Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. LARRY GROVER WASHINGTON M.S. (LICENSED PROFESSIONAL COUNSELOR)
(972) 780-5160
Entity
Organization
Contact information
Practice address
1801 N HAMPTON RD STE 410, DESOTO, TX 75115-2338
(972) 780-5160
(972) 780-5735
Mailing address
1801 N HAMPTON RD STE 410, DESOTO, TX 75115-2338
(972) 780-5160
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
19695
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9017LC
BCBS
TX
Enumeration date
06/02/2008
Last updated
03/07/2012
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