Individual
KOSHA SHETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
8202 RIDGELEA ST, DALLAS, TX 75209-2624
(214) 558-7474
Mailing address
8202 RIDGELEA ST, DALLAS, TX 75209-2624
(214) 558-7474
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
36139
TX
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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