Individual
DR. KELLY NICOLE BANNEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6701 FANNIN ST STE 1630, HOUSTON, TX 77030-2615
(832) 822-3700
(832) 825-4164
Mailing address
6701 FANNIN ST STE 1630, HOUSTON, TX 77030-2615
(832) 822-3700
(832) 825-4164
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
37690
TX
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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