Organization
PREMIER PSYCHOLOGY CONSULTANTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIETTA RICHARD PH.D. (PH.D. / PSYCHOLOGIST)
(682) 477-4400
Entity
Organization
Contact information
Practice address
1725 E SOUTHLAKE BLVD STE 102, SOUTHLAKE, TX 76092-6457
(682) 477-4400
Mailing address
1725 E SOUTHLAKE BLVD, SUITE 102, SOUTHLAKE, TX 76092
(682) 477-4400
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
06/28/2019
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