Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 24239 | TX |
NPI | 1083821482 |
---|---|
Provider Name | Dr. Helene Deborah-Lynne Pennett |
First Address | Colleyville, TX 76034-5222 |
Second Address | Hurst, TX 76053-4634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |