Individual
MARY LISA DUARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
614 W FRONT ST, ALICE, TX 78332-7112
(361) 664-9587
(361) 668-0222
Mailing address
200 MARRIOTT DR, PORTLAND, TX 78374-2213
(361) 777-3991
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1055849
TX
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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