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NPI 1295265577

NPI 1295265577 : BEHAVIORAL HEALTH DALLAS, PLLC : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1295265577
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    Entity Type          |    Organization 
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    Legal Business Name  |    BEHAVIORAL HEALTH DALLAS, PLLC 
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Dates
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    Enumeration Date     |    06/19/2017
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    Last Update Date     |    07/21/2022
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Provider Practice Location Address
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    Address Line         |    7557 RAMBLER RD STE 425 
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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            |    214-383-8145
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7557 RAMBLER RD STE 425 
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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            |    214-383-8145
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    Fax                  |    
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Authorized Official
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    Title or Position    |    LICENSED PSYCHOLOGIST
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    Name                 |    DR. KATRINA  SARDONE 
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    Credential           |    PHD
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    Telephone            |    214-383-8145
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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       |    36502
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    License Number State |    TX
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