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1699950782
MARIETTA BACCUS RICHARD
SOUTHLAKE, TX
NPI
1699950782
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Former Name
MARIETTA BACCUS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: TX 24396)
Enumeration Date
2008-01-08
Last Update Date
2019-06-28
Business Address
Dr. MARIETTA BACCUS RICHARD Ph.D
1725 E SOUTHLAKE BLVD STE 102
SOUTHLAKE, TX 76092-6457
Phone number: 682-477-4400
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Mailing Address
Dr. MARIETTA BACCUS RICHARD Ph.D
1725 E SOUTHLAKE BLVD STE 102
SOUTHLAKE, TX 76092-6457
Phone number: 682-477-4400
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