Individual
DESSIRAE BOULWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3833 DUNLAVY STREET, HOUSTON, TX 77006-4769
(281) 728-0766
Mailing address
PO BOX 66211, HOUSTON, TX 77266-6211
(281) 728-0766
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
38405
TX
103TC0700X
Clinical Psychologist
PSY28641
CA
Other
Enumeration date
10/06/2011
Last updated
10/01/2020
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