Individual
DR. CAROLYN SASANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1305 AIRPORT FWY STE 205, BEDFORD, TX 76021-6606
(817) 267-6290
(817) 267-0950
Mailing address
1305 AIRPORT FWY STE 205, BEDFORD, TX 76021-6606
(817) 267-6290
(817) 267-0950
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
34824
TX
103TS0200X
School Psychologist
31664
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01452126
AMERIGROUP
TX
05
—
2140089
—
TX
01
—
TXB148104
MEDICARE PTAN NUMBER
TX
Enumeration date
01/22/2009
Last updated
03/17/2018
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