Organization
MINDSPROUTS PERSONAL GROWTH THERAPY PLLC
Active
Organization
MINDSPROUTS PERSONAL GROWTH THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE M SICILIANO AVILA PHD (PSYCHOLOGIST/OWNER)
(214) 830-9879
Entity
Organization
Contact information
Practice address
16135 PRESTON RD STE 116, DALLAS, TX 75248-8532
(214) 830-9879
Mailing address
PO BOX 863842, PLANO, TX 75086-3842
(214) 830-9879
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
63226
TX
103TC1900X
Counseling Psychologist
Primary
37241
TX
Other
Enumeration date
08/28/2016
Last updated
03/01/2021
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