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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