Organization
VITA THERAPY PLLC
Active
Parent organization
SHANNON R. POPPITO, PHD
Other names
Shannon R. Poppito, PhD
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHANNON R. POPPITO, PHD
Authorized official
DR. SHANNON ROSE POPPITO PHD (CLINICAL PSYCHOLOGIST)
(646) 853-4376
Entity
Organization
Contact information
Practice address
10000 N CENTRAL EXPY STE 400, DALLAS, TX 75231-4180
(646) 853-4376
Mailing address
8703 FLINT FALLS DR, DALLAS, TX 75243-7540
(646) 853-4376
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
12/03/2020
Last updated
01/11/2021
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