Organization
LEGACY PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARA CONRAD-SHEARBURN PHD (LICENSED PSYCHOLOGIST)
(210) 819-5941
Entity
Organization
Contact information
Practice address
1919 OAKWELL FARMS PKWY STE 138, SAN ANTONIO, TX 78218-1725
(210) 819-5941
Mailing address
1919 OAKWELL FARMS PKWY STE 138, SAN ANTONIO, TX 78218-1725
(210) 819-5941
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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