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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