Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 60888 | TX |
NPI | 1063542868 |
---|---|
Provider Name | Michele V. Ward |
First Address | Katy, TX 77450-2500 |
Second Address | Katy, TX 77450-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 07/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
723410 | BCBSTX (01) | TX |