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Clinical Psychologist · JBSA LACKLAND, TX

Individual Active NPI 1609432657

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Clinical Psychologist103TC0700X✓071-011138IL
Student in an Organized Health Care Education/Training Program390200000X——

Medicare eligibility

Part B
Yes
DME
Yes
Home health
No
Power mobility
No
Hospice
No

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.