Organization
CREATIVE MINDS BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRALICA CLEWIS (CREDENTIAL/BILLING)
(469) 586-7643
Entity
Organization
Contact information
Practice address
110 W RANDOL MILL RD STE 200, ARLINGTON, TX 76011-4612
(214) 892-7151
(214) 602-9919
Mailing address
110 W RANDOL MILL RD STE 200, ARLINGTON, TX 76011-4612
(214) 892-7151
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
389918903
—
TX
Enumeration date
05/11/2020
Last updated
08/30/2020
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