Organization
BRILLIANT MIND BEHAVIORAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELMITH MAMO MSN,PMHNP-BC (PROVIDER)
(469) 618-5703
Entity
Organization
Contact information
Practice address
2770 MAIN ST STE 211, FRISCO, TX 75033-4439
(469) 618-5703
Mailing address
2770 MAIN ST STE 211, FRISCO, TX 75033-4439
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
AP126843
TX
Other
Enumeration date
06/15/2016
Last updated
02/20/2017
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