MEDICARE: DR. JANICE BIGBY 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
1	103TH0004X	Health Psychologist	36128	TX
2	103TS0200X	School Psychologist	33132	TX

General Provider Information

NPI Number	:	1962762781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE BIGBY PH.D.

Provider Business Mailing Address
First Line	:	1105 SANDPIPER DR
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-8034
Country	:	US
Telephone Number	:	940-231-3693
Fax Number	:

Provider Business Practice Location Address
First Line	:	4232 N INTERSTATE 35
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76207-3408
Country	:	US
Telephone Number	:	940-231-3693
Fax Number	:

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

Provider Enumeration Date	:	05/26/2012
Last Update Date	:	05/26/2012

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