Organization
THE INSTITUTE FOR CLINICAL NEURSOCIENCE, PLLC
Active
Organization
THE INSTITUTE FOR CLINICAL NEURSOCIENCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEE DOBBS (CREDENTILING)
(817) 306-0215
Entity
Organization
Contact information
Practice address
4425 W AIRPORT FWY, SUITE 250, IRVING, TX 75062-5832
(817) 306-0215
Mailing address
PO BOX 25339, COLORADO SPRINGS, CO 80936-5339
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
209800000X
Legal Medicine (M.D./D.O.) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21788
STATE LICENSE
TX
01
—
2998
STATE LICENSE
CO
Enumeration date
06/11/2014
Last updated
10/01/2014
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