Individual
LAURA LIECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSSP
Contact information
Practice address
12225 GREENVILLE AVE, DALLAS, TX 75243-9362
(866) 575-9820
Mailing address
12225 GREENVILLE AVE, DALLAS, TX 75243-9362
(866) 575-9820
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
31477
TX
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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