Healthcare Provider Details

I. General information

NPI: 1669705026
Provider Name (Legal Business Name): SONYA D. GRAY BELCHER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 09/07/2020
Certification Date: 09/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 N FIELDER RD
ARLINGTON TX
76012-4635
US

IV. Provider business mailing address

1361 PRAIRIE DR
LEWISVILLE TX
75067-5564
US

V. Phone/Fax

Practice location:
  • Phone: 972-827-8088
  • Fax:
Mailing address:
  • Phone: 972-827-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number814
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number911
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2016037433
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number38340
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: