Healthcare Provider Details

I. General information

NPI: 1134455249
Provider Name (Legal Business Name): TERRIE LYNN NARAMOR PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5512 W PLANO PKWY STE 100
PLANO TX
75093-4840
US

IV. Provider business mailing address

5512 W PLANO PKWY STE 100
PLANO TX
75093-4840
US

V. Phone/Fax

Practice location:
  • Phone: 469-941-4871
  • Fax: 469-298-9995
Mailing address:
  • Phone: 469-941-4871
  • Fax: 469-298-9995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number21044
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number34030
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: