Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 33590 | TX |
Y | 103T00000X | Psychologist | 33590 | TX |
N | 102L00000X | Psychologist | PSY18378 | CA |
N | 103T00000X | Psychologist | PSY18378 | CA |
NPI | 1013023605 |
---|---|
Provider Name | Dr. Janna Oddie Cavanaugh |
First Address | Pflugerville, TX 78660-4195 |
Second Address | Pflugerville, TX 78660-4195 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 24/01/2020 |