Provider Demographics
NPI:1710274873
Name:GORDON-HOLLINGSWORTH, ARLENE TAYAG (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:TAYAG
Last Name:GORDON-HOLLINGSWORTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11200 BROADWAY ST STE 2743
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9787
Mailing Address - Country:US
Mailing Address - Phone:281-818-6758
Mailing Address - Fax:832-895-6401
Practice Address - Street 1:11200 BROADWAY ST
Practice Address - Street 2:STE 2743
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:281-818-6758
Practice Address - Fax:832-895-6401
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36896103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty