Provider Demographics
NPI:1689745572
Name:KASSLER, DINA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:M
Last Name:KASSLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3010 SCOTT BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6800
Mailing Address - Country:US
Mailing Address - Phone:254-773-4022
Mailing Address - Fax:254-773-9019
Practice Address - Street 1:9015 MOUNTAIN RIDGE DR
Practice Address - Street 2:HOUSTON BLDG., SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7370
Practice Address - Country:US
Practice Address - Phone:512-201-4006
Practice Address - Fax:254-773-9019
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32683103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
8G0874Medicare ID - Type Unspecified