Individual
MICHAEL DAVID FARJELLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
8103 PURPLE ASTER PASS, LAGO VISTA, TX 78645-2294
(210) 844-7028
Mailing address
8103 PURPLE ASTER PASS, LAGO VISTA, TX 78645-2294
(210) 844-7028
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
247249
KY
103TC0700X
Clinical Psychologist
Primary
40363
TX
Other
Enumeration date
09/26/2008
Last updated
10/07/2024
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