Individual
DR. GERALD D SODERSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1212 BRIAR LN, WHARTON, TX 77488-4304
(979) 532-0900
Mailing address
1212 BRIAR LN, WHARTON, TX 77488-4304
(979) 532-0900
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
22059
TX
103TC1900X
Counseling Psychologist
22059
TX
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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