Individual
NUVI DOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7560 JOSHUA RD, FRISCO, TX 75033-3382
(747) 777-0255
Mailing address
7560 JOSHUA RD, FRISCO, TX 75033-3382
(747) 777-0255
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
15997
MA
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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