Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 2826 | TN |
N | 103TC0700X | Clinical Psychologist | 2826 | TN |
Y | 103G00000X | Clinical Psychologist | 35017 | TX |
Y | 103TC0700X | Clinical Psychologist | 35017 | TX |
N | 103G00000X | Clinical Psychologist | 36-654 | MS |
N | 103TC0700X | Clinical Psychologist | 36-654 | MS |
NPI | 1003037441 |
---|---|
Provider Name | Dr. Trudi Zaplac |
First Address | Victoria, TX 77901-5645 |
Second Address | Victoria, TX 77901-5645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 23/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00121883 | (05) | MS |
P54643 | (02) |