Provider Demographics
NPI:1376097931
Name:LILAND, CASSIDY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CASSIDY
Middle Name:
Last Name:LILAND
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 1:5949 SHERRY LN
Mailing Address - Street 2:SUITE 752
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6532
Mailing Address - Country:US
Mailing Address - Phone:214-890-9880
Mailing Address - Fax:
Practice Address - Street 1:5949 SHERRY LN
Practice Address - Street 2:SUITE 752
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6532
Practice Address - Country:US
Practice Address - Phone:214-890-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37417103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical