Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TC1900X | Counseling Psychologist | 36822 | |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 36822 | TX |
N | 103TF0000X | Family Psychologist | 36822 |
NPI | 1063813640 |
---|---|
Provider Name | Dr. Sara Pollard |
First Address | Dallas, TX 75235-7701 |
Second Address | Dallas, TX 75235-7701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2014 |
Last Update Date | 15/09/2014 |