Individual
BRANDY D ACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
3615 RICHMOND RD, TEXARKANA, TX 75503
(903) 791-9355
Mailing address
3515 RICHMOND RD, TEXARKANA, TX 75503-0711
(903) 791-9355
(903) 793-0496
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
37845
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37845
PROVISIONALLY LICENSED PSYCHOLOGIST
TX
Enumeration date
06/26/2018
Last updated
02/06/2020
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