Individual
JACK GRADY DIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4201 WINGREN DR, SUITE 112, IRVING, TX 75062-2763
(972) 541-0818
Mailing address
4201 WINGREN DR, SUITE 112, IRVING, TX 75062-2763
(972) 541-0818
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22641
TX
Other
Enumeration date
11/08/2011
Last updated
11/08/2011
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