A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles,...
TX license #24796taxonomy 103T00000X
Identifiers
Type
Value
Notes
01 (TX)
0095MQ
BLUE CROSS BLUE SHIELD
05 (TX)
0992653
05 (NM)
95074732
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
Lighthouse Behavioral Health
Type code 3recorded 2020-12-15
Lighthouse Behavioral Health
Type code 3recorded 2005-12-27
Practice context
Multi-provider organization.
1 individual provider on file at this primary address.
Plus 1 secondary practice location.
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