Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TS0200X | School Psychologist |
NPI | 1093486755 |
---|---|
Provider Name | Dr. Kelly Poirot |
First Address | Katy, TX 77494-1028 |
Second Address | Katy, TX 77494-3429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2021 |
Last Update Date | 22/09/2021 |