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Individual

DR. LASANDRA WARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1650 W ROSEDALE ST STE 305, FORT WORTH, TX 76104-7400
(682) 841-1475
Mailing address
1650 W ROSEDALE ST STE 305, FORT WORTH, TX 76104-7400
(682) 841-1475

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
33996
TX
103TC0700X
Clinical Psychologist
Primary
33996
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33996
TEXAS LICENSE
TX
Enumeration date
12/27/2018
Last updated
12/27/2018
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