| NPI | 1992258552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY REISS Psychologist 469-247-9656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36332) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 36332) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 36332) | |
| 103TF0000X Psychologist, Family (Licence: TX 36332) | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |