Individual
DR. NANCY A DIDRIKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
997 HAMPSHIRE LANE, STE 200, RICHARDSON, TX 75080-8104
(972) 889-9933
(972) 889-9935
Mailing address
997 HAMPSHIRE LANE, STE 200, RICHARDSON, TX 75080-8104
(972) 889-9933
(972) 889-9935
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
23529
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179804900
OWCP INDIVIDUAL PROVIDER
TX
01
—
179804900
US DEPT OF LABOR
—
01
—
680009955
RR MEDICARE PROVIDER #
TX
Enumeration date
07/28/2006
Last updated
01/28/2021
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