Healthcare Provider Details

I. General information

NPI: 1386961746
Provider Name (Legal Business Name): CLARISSA IVETTE KUHNS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 DENMARK LN
LAREDO TX
78045-8388
US

IV. Provider business mailing address

1705 DENMARK LN
LAREDO TX
78045-8388
US

V. Phone/Fax

Practice location:
  • Phone: 956-645-3643
  • Fax:
Mailing address:
  • Phone: 956-645-3643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number34547
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number34174
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: