Individual
MARY NEWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7199 RENDON BLOODWORTH RD, MANSFIELD, TX 76063-4925
(817) 808-7172
(817) 483-1294
Mailing address
7199 RENDON BLOODWORTH RD, MANSFIELD, TX 76063-4925
(817) 808-7172
(817) 483-1294
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
136646
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5646500178
—
TX
Enumeration date
11/13/2013
Last updated
11/13/2013
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