Individual
DR. SUSAN B REBILLET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6330 LYNDON B JOHNSON FWY, SUITE 234, DALLAS, TX 75240-6467
(214) 789-4027
Mailing address
2610 ALLEN ST, SUITE 1601, DALLAS, TX 75204-2500
(214) 789-4027
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31766
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518748-04
—
TX
Enumeration date
06/19/2006
Last updated
07/02/2010
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