Organization
BRAVO MIND PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA VILLASENOR NARDINI MD (MANAGING MEMBER)
(210) 201-2656
Entity
Organization
Contact information
Practice address
4405 7TH AVE SE STE 200, LACEY, WA 98503-1055
(210) 201-2656
Mailing address
13423 BLANCO RD UNIT 3164, SAN ANTONIO, TX 78216-2187
(210) 201-2656
(863) 228-8489
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/03/2024
Last updated
12/29/2025
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