Individual
AUTUMN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7028 ORION DR, GRAND PRAIRIE, TX 75054-7247
(307) 253-9308
(307) 215-5521
Mailing address
7028 ORION DR, GRAND PRAIRIE, TX 75054-7247
(307) 253-9308
(307) 215-5521
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/05/2016
Last updated
02/08/2024
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