Individual
NICOLE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
17100 GLENMOUNT PARK DR STE C, WEBSTER, TX 77598-4368
(281) 407-5658
Mailing address
5521 ASPEN ST, HOUSTON, TX 77081-6603
(713) 702-8195
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
35138
TX
103TS0200X
School Psychologist
Primary
35138
TX
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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