Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 12661 | TX |
N | 101YS0200X | School Counselor | ||
N | 103K00000X | Behavior Analyst | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities |
NPI | 1255563854 |
---|---|
Provider Name | Clara M. Samuelson |
First Address | Sugar Land, TX 77479-2319 |
Second Address | Sugar Land, TX 77479-2319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2009 |
Last Update Date | 30/09/2009 |