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General NPI Number Information
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NPI Number | 1780079822
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Entity Type | Organization
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Legal Business Name | CROFT CADERAO & HOLLAND PLLC
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 3500 OAK LAWN AVE SUITE 230
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City | DALLAS
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State | TX
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Zip | 75219-4308
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Country | US
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Telephone | 214-305-2110
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 OAK LAWN AVE SUITE 230
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City | DALLAS
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State | TX
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Zip | 75219-4308
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Country | US
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Telephone | 214-305-2110
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST & SUPERVISOR
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Name | JAMILE A. ASHMORE
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Credential | PH.D.
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Telephone | 214-305-2110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 33150
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License Number State | TX
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