Organization
EAST TEXAS NEUROBEHAVIORAL HEALTH,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE M GARD PH.D. (OWNER/CLINICAL PSYCHOLOGIST)
(903) 887-0697
Entity
Organization
Contact information
Practice address
122 S GUN BARREL LN, SUITE 6, GUN BARREL CITY, TX 75156-9403
(903) 887-0697
(903) 887-0698
Mailing address
PO BOX 2107, MABANK, TX 75147-5017
(903) 887-0697
(903) 887-0698
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
33829
TX
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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