Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 21136 | TX |
Y | 103T00000X | Psychologist | 21136 | TX |
N | 103TC1900X | Counseling Psychologist | 21136 | TX |
N | 103TH0100X | Health Service | 21136 | TX |
N | 103TR0400X | Rehabilitation Psychologist | 21136 | TX |
NPI | 1568501146 |
---|---|
Provider Name | Dr. Ellen Margaret Levin |
First Address | Houston, TX 77019-5308 |
Second Address | Pasadena, TX 77504-1871 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 10/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PG1424 | (02) | TX |