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1336156975
MARK S RIDER
SOUTHLAKE, TX
NPI
1336156975
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: TX 24516)
Enumeration Date
2006-08-02
Last Update Date
2009-06-08
Business Address
-- MARK S RIDER PhD
558 SILICON DR #102
SOUTHLAKE, TX 76092-7529
Phone number: 817-442-1707
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Mailing Address
-- MARK S RIDER PhD
558 SILICON DR #102
SOUTHLAKE, TX 76092-7529
Phone number: 817-442-1707
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