Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 59427 | TX |
N | 102L00000X | Psychologist | 59427 | TX |
N | 103T00000X | Psychologist | 59427 | TX |
NPI | 1003080508 |
---|---|
Provider Name | Mrs. Marisa Mcnamara Byers |
First Address | Wichita Falls, TX 76301-6810 |
Second Address | Wichita Falls, TX 76301-6810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 11/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
199013703 | (05) | TX |