Healthcare Provider Details

I. General information

NPI: 1437665569
Provider Name (Legal Business Name): JAMIE SUE KLUGIEWICZ PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE SUE SNIDER

II. Dates (important events)

Enumeration Date: 12/27/2017
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 N CENTRAL EXPY STE 230
DALLAS TX
75231-6079
US

IV. Provider business mailing address

1104 NEWPORT DR
ALLEN TX
75013-2807
US

V. Phone/Fax

Practice location:
  • Phone: 214-818-5765
  • Fax:
Mailing address:
  • Phone: 903-316-8572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number40140
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: