Individual
MS. ANNETTE MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2401 MUSTANG DR, SUITE 200, GRAPEVINE, TX 76051-8640
(817) 481-7474
(817) 416-0900
Mailing address
2401 MUSTANG DR, SUITE 200, GRAPEVINE, TX 76051-8640
(817) 481-7474
(817) 416-0900
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
15838
TX
363LF0000X
Family Nurse Practitioner
Primary
AP135862
TX
Other
Enumeration date
04/02/2007
Last updated
11/28/2017
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