Ccpcs

NPI #1164756565 in Waco, Texas

Provider Information

NPI Number
1164756565
Entity Type
Organization
Organization Name
Ccpcs
Primary Specialty
Community/Behavioral Health
Enumeration Date
Oct 1, 2009
Last Updated
Oct 1, 2009

Practice Location

Address
305 LONDONDERRY DR STE 7
City
Waco
State
Texas
ZIP Code
76712-7906
Phone
(254) 776-7792

Authorized Official

Name
DR. TAMARA LYNN HODGES
Title
PSYCHOLOGIST
Phone
(254) 776-7792

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health

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