Organization
MODERN PSYCHOLOGICAL & ALLIED SERVICES, PLLC
Active
Organization
MODERN PSYCHOLOGICAL & ALLIED SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEVON J SUPERVILLE PH.D. (PRESIDENT)
(940) 632-6844
Entity
Organization
Contact information
Practice address
6201 BONHOMME RD STE 178N, HOUSTON, TX 77036
(281) 771-2685
Mailing address
3 SUGAR CREEK CENTER BLVD STE 100, SUGAR LAND, TX 77478-2211
(281) 771-2685
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
33636
TX
103TC0700X
Clinical Psychologist
Primary
33636
TX
251S00000X
Community/Behavioral Health Agency
33636
TX
Other
Enumeration date
04/14/2016
Last updated
07/31/2018
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