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General NPI Number Information
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NPI Number | 1215201876
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Entity Type | Organization
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Legal Business Name | DALLAS CBT PLLC
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 7557 RAMBLER RD SUITE 1100
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City | DALLAS
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State | TX
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Zip | 75231-4142
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Country | US
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Telephone | 214-476-6176
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Fax |
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Provider Business Mailing Address
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Address Line | 5904 JUNIUS ST
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City | DALLAS
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State | TX
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Zip | 75214-4428
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Country | US
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Telephone | 214-768-4125
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASPER SMITS
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Credential | PH.D.
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Telephone | 214-768-4125
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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 | 33238
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License Number State | TX
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