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NPI Code Detail

MEDICARE: DR. MARY YOUNT COTELLESSE PH.D.

MEDICARE:  DR. MARY YOUNT COTELLESSE  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist2-3737TX

General Provider Information

NPI Number : 1285720094
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY YOUNT COTELLESSE PH.D.
Provider Business Mailing Address
First Line : 7575 SAN FELIPE ST
Second Line : SUITE 130
City : HOUSTON
State : TX
Zip : 77063-1711
Country : US
Telephone Number : 713-781-0555
Fax Number : 713-781-1319
Provider Business Practice Location Address
First Line : 7575 SAN FELIPE ST
Second Line : SUITE 130
City : HOUSTON
State : TX
Zip : 77063-1711
Country : US
Telephone Number : 713-781-0555
Fax Number : 713-781-1319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MARY YOUNT COTELLESSE PH.D.” Practice Location

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