MEDICARE: DR. GILDA L. KESSNER PSY.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
1	103T00000X	Psychologist	26886	TX

General Provider Information

NPI Number	:	1407181282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GILDA L. KESSNER PSY.D.

Provider Business Mailing Address
First Line	:	PO BOX 181954
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-8954
Country	:	US
Telephone Number	:	214-455-7692
Fax Number	:

Provider Business Practice Location Address
First Line	:	10215 KILARNEY DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-2932
Country	:	US
Telephone Number	:	214-455-7692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2009
Last Update Date	:	10/12/2009

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