Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1194-0991 | TX |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | AD003151 | TX |
N | 103TA0700X | Adult Development & Aging Psychologist | 21086 | TX |
N | 103TA0700X | Adult Development & Aging Psychologist | 649 | OK |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 964097 | TX |
N | 103G00000X | Clinical Psychologist | 21086 | TX |
N | 103TC0700X | Clinical Psychologist | 21086 | TX |
N | 103G00000X | Clinical Psychologist | 649 | OK |
N | 103TC0700X | Clinical Psychologist | 649 | OK |
N | 103TC1900X | Counseling Psychologist | 21086 | TX |
N | 103TC1900X | Counseling Psychologist | 649 | OK |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 21086 | TX |
N | 103TF0200X | Forensic Psychologist | 21086 | TX |
N | 103TF0200X | Forensic Psychologist | 649 | OK |
N | 103TH0100X | Health Service | 12505 | TX |
N | 103TR0400X | Rehabilitation Psychologist | 94161 | TX |
N | 103TS0200X | School Psychologist | 5908 | TX |
NPI | 1104896778 |
---|---|
Provider Name | Dr. Joann Catherine Ondrovik |
First Address | Paris, TX 75462-3058 |
Second Address | Paris, TX 75462-3058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AN79 | BC/BS PROVIDER ID (01) | TX |
972530 | FIRST HEALTH (01) | TX |