Provider Demographics
NPI:1417255423
Name:RAWLEY, JENNIFER (PSY, D)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:RAWLEY
Suffix:
Gender:F
Credentials:PSY, D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8623 WESTGLEN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-4116
Mailing Address - Country:US
Mailing Address - Phone:214-417-9538
Mailing Address - Fax:
Practice Address - Street 1:2625 N JOSEY LN
Practice Address - Street 2:SUITE 250
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5543
Practice Address - Country:US
Practice Address - Phone:972-466-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35098103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical