Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 25811 | TX |
N | 103TC0700X | Clinical Psychologist | 25811 | TX |
Y | 103TR0400X | Rehabilitation Psychologist | 25811 | TX |
NPI | 1720539794 |
---|---|
Provider Name | Dr. Kier Bison |
First Address | Frisco, TX 75034-6066 |
Second Address | Frisco, TX 75034-6066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2016 |
Last Update Date | 14/10/2016 |