NPI age
17 years
Enumerated 2008-12-30
Across 3401 active psychologist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 11987351 | CAQH |
| 01 (TX) | 34212 | LICENSE |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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