Individual
MRS. SHIRLEY ANNE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2340 W INTERSTATE 20, BLDG. HR-II, STE. 206, ARLINGTON, TX 76017-7620
(814) 466-2585
(817) 466-2596
Mailing address
2340 W INTERSTATE 20, BLDG. HR-II, STE. 206, ARLINGTON, TX 76017-7620
(814) 466-2585
(817) 466-2596
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
21860
TX
103T00000X
Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00H45R
BCBS
TX
05
—
096833101
—
TX
Enumeration date
11/28/2006
Last updated
03/22/2012
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