Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 04874 | MD |
Y | 103TC0700X | Clinical Psychologist | 04874 | MD |
NPI | 1003119488 |
---|---|
Provider Name | Rebecca M Pasillas |
First Address | El Paso, TX 79995-9520 |
Second Address | El Paso, TX 79905-2709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2010 |
Last Update Date | 19/12/2012 |