| NPI | 1396993093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN DELEA HERBER Psychologist 817-798-4324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 32212) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 32212) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 32212) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 33212) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: TX 32212) | |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-09-05 |