Organization
KRISTA KULESZA, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTA KULESZA PH.D. (LICENSED PSYCHOLOGIST)
(682) 554-2946
Entity
Organization
Contact information
Practice address
305 MIRON DR, SOUTHLAKE, TX 76092-7831
(682) 554-2946
(866) 573-1719
Mailing address
305 MIRON DR, SOUTHLAKE, TX 76092-7831
(682) 554-2946
(866) 573-1719
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
33605
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312422401
—
TX
Enumeration date
04/08/2014
Last updated
04/08/2014
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