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1699052555
STACI GOTTLIEB
FORT WORTH, TX
NPI
1699052555
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX 741675)
Enumeration Date
2011-11-07
Last Update Date
2016-07-29
Business Address
-- STACI GOTTLIEB RN, MSN, PMHNP
901 7TH AVE SUITE 230
FORT WORTH, TX 76104-2722
Phone number: 682-885-1050
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Mailing Address
-- STACI GOTTLIEB RN, MSN, PMHNP
PO BOX 99371
FORT WORTH, TX 76199-0371
Phone number: 682-885-1855
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