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Individual

DR. CLYDE O HANKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1438 MARLENE PL, DESOTO, TX 75115-2907
(214) 850-6580
Mailing address
1438 MARLENE PL, DESOTO, TX 75115-2907
(214) 850-6580

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
24895
TX
106H00000X
Marriage & Family Therapist
3853
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
131884203
TX
Enumeration date
07/17/2006
Last updated
04/29/2019
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