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General NPI Number Information
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NPI Number | 1194040709
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Entity Type | Organization
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Legal Business Name | MISCHCA T. SCALES, PHD, PLLC
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 12/31/2010
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Provider Practice Location Address
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Address Line | 111 N HASLER BLVD SUITE 207
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City | BASTROP
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State | TX
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Zip | 78602-3831
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Country | US
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Telephone | 512-507-6342
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Fax | 512-531-9271
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Provider Business Mailing Address
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Address Line | 7417 TURNBUOY DR
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City | AUSTIN
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State | TX
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Zip | 78730-4333
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Country | US
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Telephone | 512-507-6342
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Fax | 512-531-9271
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MISCHCA T SCALES
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Credential | PHD
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Telephone | 512-507-6342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 31559
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License Number State | TX
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