Individual
DR. MICHAEL ROBERT LAVALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7557 RAMBLER RD STE 430, DALLAS, TX 75231-2378
(214) 750-1086
(214) 750-1971
Mailing address
7557 RAMBLER RD STE 430, DALLAS, TX 75231-2378
(214) 750-1086
(214) 750-1971
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
23462
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2-3462
STATE LICENSE
TX
01
—
41699
HEALTH SEVICE PROVIDER
—
01
—
75-2362687
TAX ID
—
Enumeration date
02/02/2007
Last updated
10/10/2024
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