Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 25075 | TX |
NPI | 1003012295 |
---|---|
Provider Name | Dr. Julie Ann Landis |
First Address | Bellaire, TX 77401-4527 |
Second Address | Bellaire, TX 77401-4527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 08/07/2007 |