Individual
DR. JAYNE M RAQUEPAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3400 BISSONNET ST, STE 280, HOUSTON, TX 77005-2192
(713) 909-4841
Mailing address
3400 BISSONNET ST, STE 280, HOUSTON, TX 77005-2192
(713) 909-4841
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
24154
TX
103TC1900X
Counseling Psychologist
24154
TX
103TE1100X
Exercise & Sports Psychologist
24154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099272902
—
TX
Enumeration date
05/03/2007
Last updated
08/27/2022
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