Provider Demographics
NPI:1497373955
Name:OLSTHOORN, INEKE MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:INEKE
Middle Name:MARIA
Last Name:OLSTHOORN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17189 INTERSTATE 45 S STE 675
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3320
Mailing Address - Country:US
Mailing Address - Phone:936-270-3900
Mailing Address - Fax:936-271-1584
Practice Address - Street 1:17189 INTERSTATE 45 S STE 675
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3320
Practice Address - Country:US
Practice Address - Phone:936-270-3900
Practice Address - Fax:936-271-1584
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39320103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist