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General NPI Number Information
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NPI Number | 1558979443
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Entity Type | Organization
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Legal Business Name | STAR NEUROPSYCHOLOGY, PLLC
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Dates
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Enumeration Date | 07/16/2020
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Last Update Date | 07/16/2020
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Provider Practice Location Address
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Address Line | 9741 PRESTON RD STE 203
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City | FRISCO
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State | TX
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Zip | 75033-2554
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Country | US
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Telephone | 415-730-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 8992 PRESTON RD STE 110-760
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City | FRISCO
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State | TX
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Zip | 75034-3965
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Country | US
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Telephone | 415-730-1177
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Fax |
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Authorized Official
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Title or Position | OWNER/ CLINICAL NEUROPSYCHOLOGIST
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Name | DR. MARIE DAHDAH
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Credential | PH.D.
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Telephone | 415-730-1177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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