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General NPI Number Information
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NPI Number | 1538256771
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Entity Type | Organization
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Legal Business Name | NORTH DALLAS PSYCHOLOGICAL PRACTICE
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 6330 LBJ FWY STE 236
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City | DALLAS
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State | TX
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Zip | 75240-6431
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Country | US
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Telephone | 972-231-1211
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Fax | 972-231-1211
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Provider Business Mailing Address
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Address Line | 6330 LBJ FWY STE 236
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City | DALLAS
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State | TX
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Zip | 75240-6431
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Country | US
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Telephone | 972-231-1211
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Fax | 972-231-1211
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | DR. NEIL F. RAVELLA
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Credential | PH.D.
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Telephone | 972-231-1211
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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 |
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License Number State |
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