Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 36004 | TX |
NPI | 1073945671 |
---|---|
Provider Name | Dr. Tara Lynn Cummings |
First Address | Cypress, TX 77429 |
Second Address | Cypress, TX 77429-8066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2013 |
Last Update Date | 06/08/2013 |