Organization
TABULA RASA PSYCHOLOGY, PLLC
Active
Organization
TABULA RASA PSYCHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLYTHE TWOSISTERS PSYD (MANAGER/OWNER)
(214) 997-4697
Entity
Organization
Contact information
Practice address
2636 S LOOP W #550-A, HOUSTON, TX 77054
(432) 698-0141
(281) 605-6722
Mailing address
2636 S LOOP W #550-A, HOUSTON, TX 77054
(432) 698-0141
(281) 605-6722
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
36566
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4067100
—
TX
Enumeration date
11/12/2017
Last updated
08/22/2024
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