Individual
JILL MARY WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000
(214) 443-7309
Mailing address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000
(214) 443-7309
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1282
LA
103TC0700X
Clinical Psychologist
1282
LA
103TC0700X
Clinical Psychologist
Primary
39494
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05529882
—
MS
05
—
2384902
—
LA
Enumeration date
09/15/2014
Last updated
09/14/2022
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