Provider Demographics
NPI:1326570342
Name:ROLLINS, DAHL (PHD)
Entity Type:Individual
Prefix:
First Name:DAHL
Middle Name:
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17514 PROSPECT MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-7192
Mailing Address - Country:US
Mailing Address - Phone:713-304-2084
Mailing Address - Fax:
Practice Address - Street 1:17030 NANES DR STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2504
Practice Address - Country:US
Practice Address - Phone:281-415-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33067103TS0200X
TX34508103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool