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Organization

DEPARTMENT OF VETERAN AFFAIRS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIANA WILLIS L.M.S.W. (MENTAL HEALTH SOCIAL WORKER)
(214) 857-0912
Entity
Organization

Contact information

Practice address
4500 S LANCASTER RD, MH COPPER TEAM 116A, DALLAS, TX 75216-7167
(214) 857-0912
Mailing address
610 JAGERA WAY, ARLINGTON, TX 76002-4582
(214) 857-0912

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
50681
TX

Other

Enumeration date
05/14/2007
Last updated
01/25/2008
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