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General NPI Number Information
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NPI Number | 1568797603
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Entity Type | Individual
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Provider Name | REBECCA CORONA PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 4201 BROOK SPRING DR
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City | DALLAS
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State | TX
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Zip | 75224-4968
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Country | US
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Telephone | 214-266-1437
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Fax | 214-266-4218
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Provider Business Mailing Address
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Address Line | 101 N BROOKSIDE DR #903
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City | DALLAS
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State | TX
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Zip | 75214-4523
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Country | US
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Telephone | 915-240-6805
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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 | 34557
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License Number State | TX
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