Organization
TERESA REJUVENATING PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAMBO JINGLA NDINGWAN NP (CEO)
(409) 356-9778
Entity
Organization
Contact information
Practice address
10412 CHINA SPRING RD, WACO, TX 76708-5676
(254) 717-3066
Mailing address
10412 CHINA SPRING RD, WACO, TX 76708-5676
(409) 356-9778
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/31/2022
Last updated
09/07/2022
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