Provider Demographics
NPI:1528218120
Name:KIDS BRAIN, LLC
Entity Type:Organization
Organization Name:KIDS BRAIN, LLC
Other - Org Name:KIDS BRAIN
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-360-9044
Mailing Address - Street 1:13500 MIDWAY RD.,
Mailing Address - Street 2:SUITE 314
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244
Mailing Address - Country:US
Mailing Address - Phone:214-360-9044
Mailing Address - Fax:214-360-9044
Practice Address - Street 1:13500 MIDWAY RD.,
Practice Address - Street 2:SUITE 314
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244
Practice Address - Country:US
Practice Address - Phone:214-360-9044
Practice Address - Fax:214-360-9044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33794103TC2200X
TX11435192251P0200X
TX109104225XP0200X
TX106894235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty