Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 24487 | TX |
N | 103T00000X | Psychologist | 24487 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 24487 | TX |
Y | 103G00000X | Clinical Psychologist | 24487 | TX |
Y | 103TC0700X | Clinical Psychologist | 24487 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 24487 | TX |
N | 103TH0004X | Health Psychologist | 24487 | TX |
N | 103TH0100X | Health Service | 24487 | TX |
N | 103TM1800X | Intellectual & Developmental Disabilities | 24487 | TX |
N | 103TP2701X | Group Psychotherapist | 24487 | TX |
N | 103TS0200X | School Psychologist | 6535 | TX |
NPI | 1013125376 |
---|---|
Provider Name | Dr. M Teresa Nezworski |
First Address | El Paso, TX 79912-3134 |
Second Address | El Paso, TX 79912-3134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2007 |
Last Update Date | 02/03/2012 |