Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 38401 | TX |
N | 103TH0004X | Health Psychologist | 38401 | TX |
NPI | 1083293526 |
---|---|
Provider Name | Dr. Ashley Elizabeth Teasdale |
First Address | Houston, TX 77030-3000 |
Second Address | Houston, TX 77030-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2021 |
Last Update Date | 23/06/2021 |