Individual
ALLEGRA ANTWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11661 PRESTON RD STE 260, DALLAS, TX 75230-6108
(469) 658-1819
Mailing address
11661 PRESTON RD STE 260, DALLAS, TX 75230-6108
(469) 658-1819
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/27/2017
Last updated
06/16/2020
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