Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
Y | 102L00000X | Psychologist | 36138 | TX |
Y | 103T00000X | Psychologist | 36138 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 36138 | TX |
NPI | 1265833206 |
---|---|
Provider Name | Dr. Katherine Pang |
First Address | Dallas, TX 75214-3922 |
Second Address | Dallas, TX 75214-3922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2014 |
Last Update Date | 30/11/2015 |