Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 35028 | TX |
Y | 103T00000X | Psychologist | 35028 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 35028 | TX |
N | 103G00000X | Clinical Psychologist | 35028 | TX |
N | 103TC0700X | Clinical Psychologist | 35028 | TX |
NPI | 1104309350 |
---|---|
Provider Name | Kristina Nicole Zills |
First Address | The Woodlands, TX 77380 |
Second Address | The Woodlands, TX 77380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2018 |
Last Update Date | 17/10/2018 |