Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 37394 | TX |
Y | 103T00000X | Psychologist | 37394 | TX |
N | 103G00000X | Clinical Psychologist | 37394 | TX |
N | 103TC0700X | Clinical Psychologist | 37394 | TX |
N | 103TC1900X | Counseling Psychologist | 37394 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 37394 | TX |
NPI | 1013341007 |
---|---|
Provider Name | Karina Belen Samaniego Estrada |
First Address | Irving, TX 75063-0020 |
Second Address | Irving, TX 75062-4576 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2013 |
Last Update Date | 04/06/2019 |