Provider Demographics
NPI:1447966387
Name:DELIGHTED PSYCHIATRY AND WELLNESS CARE PROFESSIONAL LIMITED LIABILITY
Entity type:Organization
Organization Name:DELIGHTED PSYCHIATRY AND WELLNESS CARE PROFESSIONAL LIMITED LIABILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:AMINATA
Authorized Official - Middle Name:
Authorized Official - Last Name:WANE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:210-793-5361
Mailing Address - Street 1:8190 BARKER CYPRESS RD SUITE 1900PMB 2006
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:210-793-5361
Mailing Address - Fax:
Practice Address - Street 1:3648 CYPRESS CREEK PKWY STE 227C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3610
Practice Address - Country:US
Practice Address - Phone:210-793-5361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty