Organization Name: | INTEGRATIVE PSYCHOLOGICAL SERVICES, PLLC |
NPI Number: | 1386073906 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JESSICA BUSS (CLINICAL PSYCHOLOGIST) |
Mailing Address: | 11701 Bee Caves Rd Ste. 205 Bee Cave |
State: | TX US |
Postal Code: | 787385557 |
Phone Number: | 5122618273 |
Fax Number: | 8887462837 |
NPI Enumeration Date: | 11/04/2013 |
NPI Last Update Date: | 03/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TB0200X |
License Number: | 36486 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Cognitive & Behavioral |
Taxonomy Definition: |