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General NPI Number Information
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NPI Number | 1922814326
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Entity Type | Organization
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Legal Business Name | DOUGLAS & ASSOCIATES PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 3206 LONGMIRE DR STE A15
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City | COLLEGE STATION
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State | TX
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Zip | 77845-5858
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Country | US
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Telephone | 979-703-0616
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Fax |
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Provider Business Mailing Address
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Address Line | 3206 LONGMIRE DR STE A15
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City | COLLEGE STATION
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State | TX
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Zip | 77845-5858
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Country | US
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Telephone | 979-703-0616
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAMILLE ASHLEY DE LEONARDIS
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Credential | PSYD
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Telephone | 979-703-0616
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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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