Individual
DR. AMANDA KALLSTROM-FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1600 UNIVERSITY DRIVE, COLLEGE STATION, TX 77840
(979) 691-3397
(979) 691-3332
Mailing address
1600 UNIVERSITY DRIVE, COLLEGE STATION, TX 77840
(979) 691-3397
(979) 691-3332
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
33603
TX
Other
Enumeration date
11/07/2007
Last updated
11/07/2007
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