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General NPI Number Information
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NPI Number | 1972580637
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Entity Type | Individual
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Provider Name | KAREN D RASILE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/23/2005
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Last Update Date | 11/21/2013
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Provider Practice Location Address
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Address Line | 105 E MAIN ST
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City | BRENHAM
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State | TX
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Zip | 77833-0901
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Country | US
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Telephone | 979-530-8616
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Fax | 979-421-6039
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Provider Business Mailing Address
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Address Line | PO BOX 2346
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City | BRENHAM
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State | TX
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Zip | 77834-2346
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Country | US
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Telephone | 979-530-8616
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Fax | 979-421-6039
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 24055
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License Number State | TX
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