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General NPI Number Information
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NPI Number | 1235229766
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Entity Type | Individual
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Provider Name | APRIL MINATREA PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/30/2017
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Provider Practice Location Address
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Address Line | 211 E SOUTHLAKE BLVD SUITE 115
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6265
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Country | US
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Telephone | 817-404-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 211 E SOUTHLAKE BLVD SUITE 115
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6265
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Country | US
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Telephone | 817-404-7999
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1685
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 34028
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License Number State | TX
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