Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 22603 | TX |
Y | 103TC0700X | Clinical Psychologist | 22603 | TX |
N | 103TF0200X | Forensic Psychologist | 22603 | TX |
N | 103TH0100X | Health Service | 22306 | TX |
NPI | 1083857932 |
---|---|
Provider Name | Dr. Tana Sue Slay |
First Address | Houston, TX 77006-5818 |
Second Address | Houston, TX 77006-5818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2009 |
Last Update Date | 30/11/2011 |