Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 14663 | TX |
NPI | 1073671152 |
---|---|
Provider Name | Dr. Lisa S Wechsler |
First Address | Dallas, TX 75252-5618 |
Second Address | Dallas, TX 75252-5618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 08/07/2007 |