FRED IMUENTINYAN

SOUTHLAKE, TX
NPI1508680174
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist Clinical
(Licence: TX  40056)
Enumeration Date2024-11-11
Last Update Date2024-11-11
Business Address
DR. FRED IMUENTINYAN PHD
1500 CORPORATE CIR STE 7
SOUTHLAKE, TX 76092-5954
Phone number: 817-677-0449
Mailing Address
DR. FRED IMUENTINYAN PHD
8709 PRAIRIE DAWN DR
FORT WORTH, TX 76131-3363
Phone number:
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