Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3037 | TX |
NPI | 1083624019 |
---|---|
Provider Name | Sara Dolores Bailey |
First Address | Houston, TX 77007-2514 |
Second Address | Houston, TX 77030-4211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/07/2007 |