Organization · Type 2 NPI
On Epiphany Lane, LLC
Multi-Specialty Clinic/Center · Dallas, TX
NPI number
1891396313
Active
Practice location
603 Munger Ave Ste 100
Dallas, TX 75202-1840
Mailing address
603 Munger Ave # 100-239
Dallas, TX 75202-1839
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Professional Counselor | 101YP2500X | None listed |
| Public Health or Welfare Agency | 251K00000X | None listed |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | None listed |
| Multi-Specialty Clinic/Center Primary | 261QM1300X | None listed |
Multi-Specialty Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1891396313
On Epiphany Lane, LLC's National Provider Identifier is 1891396313, issued on Nov 2, 2020. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Dallas, TX. The record was last updated on Nov 2, 2020.