Organization
DIVINE BEHAVIORAL HEALTH CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IJEOMA E OSUJI PMHNP (OWNER)
(817) 874-2965
Entity
Organization
Contact information
Practice address
539 W COMMERCE ST STE 5507, DALLAS, TX 75208-1953
(817) 874-2965
Mailing address
803 MERYTON CT, MANSFIELD, TX 76063-4337
(178) 742-9658
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/19/2023
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