Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 2-4965 | TX |
N | 103TC0700X | Clinical Psychologist | 2-4965 | TX |
N | 103G00000X | Clinical Psychologist | 2-4965 | TX |
N | 103TC0700X | Clinical Psychologist | 2-4965 | TX |
NPI | 1003952920 |
---|---|
Provider Name | Karen O. Anderson |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S52913 | (02) |