Healthcare Provider Details
I. General information
NPI: 1033407291
Provider Name (Legal Business Name): IESHEA DANIELLA JARMON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/20/2011
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
806 N HIGHWAY 67 STE C
CEDAR HILL TX
75104
US
IV. Provider business mailing address
PO BOX 3294
CEDAR HILL TX
75106-3294
US
V. Phone/Fax
- Phone: 469-454-8277
- Fax: 866-451-6890
- Phone: 469-454-8277
- Fax: 866-451-6890
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 35189 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: