Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1023789138 |
---|---|
Provider Name | Bushra Hanif |
First Address | Tyler, TX 75703-0114 |
Second Address | Kilgore, TX 75662-5825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2021 |
Last Update Date | 28/09/2021 |