Individual
KATHY DEORNELLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
31293
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026701502
—
TX
Enumeration date
07/03/2006
Last updated
08/11/2010
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