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1962012146
AUDRA COSTON
GRAND PRAIRIE, TX
NPI
1962012146
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX AP146041)
Enumeration Date
2020-08-03
Last Update Date
2020-11-03
Business Address
AUDRA COSTON PMHNP
1171 107TH ST
GRAND PRAIRIE, TX 75050-2502
Phone number: 972-597-0843
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Mailing Address
AUDRA COSTON PMHNP
1171 107TH ST
GRAND PRAIRIE, TX 75050-2502
Phone number: 972-597-0843
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