Individual
GRACE SYOMBUA JEDIDAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
539 W COMMERCE ST # 3213, DALLAS, TX 75208-1953
(682) 593-0477
(682) 593-0477
Mailing address
539 W COMMERCE ST # 3213, DALLAS, TX 75208-1953
(682) 593-0477
(682) 593-0477
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1059626
TX
Other
Enumeration date
06/18/2022
Last updated
01/23/2025
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