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Individual

DR. VIRGINIA PENN-BENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1800 AUGUSTA DR., SUITE 109, HOUSTON, TX 77057-3131
(713) 781-1669
(713) 781-0442
Mailing address
1800 AUGUSTA DR., SUITE 109, HOUSTON, TX 77057-3131
(713) 781-1669
(713) 781-0442

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
25031
TX
103TC0700X
Clinical Psychologist
25031
TX
103TC1900X
Counseling Psychologist
Primary
25031
TX
103TC2200X
Clinical Child & Adolescent Psychologist
25031
TX
103TF0000X
Family Psychologist
25031
TX
103TP0814X
Psychoanalysis Psychologist
25031
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360216-01
TX
Enumeration date
07/21/2006
Last updated
08/22/2008
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