Most Relevant Information
Provider Data
| NPI Number: | 1003213331 |
| Provider Name: | NINA MASON |
| Entity Type: | Individual |
| Taxonomy Code: | 320600000X |
| Specialty: | Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/02/2014 |
| Last Updated: | 12/02/2014 |
Provider Practice Location
1330 FORDHAM RD
DALLAS
TX
752166219
Practice Location Phone/Fax
| Phone: | 2147498013 |
| Fax: |
Provider Mailing Location
1330 FORDHAM RD
DALLAS
TX
752166219
Provider Mailing Phone/Fax
| Phone: | 2147498013 |
| Fax: |