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Organization

MIND BODY WELLNESS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTI ROPER PH.D. (PARTNER)
(214) 763-1985
Entity
Organization

Contact information

Practice address
17304 PRESTON RD STE 800, DALLAS, TX 75252-5645
(972) 849-8987
Mailing address
PO BOX 934068, MARGATE, FL 33093-4068
(954) 366-2700
(954) 366-2056

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103T00000X
Psychologist
Primary
104100000X
Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
178166801
TX
Enumeration date
06/10/2006
Last updated
02/22/2021
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