Provider Demographics
NPI:1841735172
Name:DR. LOVE AND ASSOCIATES PSYCHOLOGICAL PRACTICE
Entity Type:Organization
Organization Name:DR. LOVE AND ASSOCIATES PSYCHOLOGICAL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVITTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-644-5185
Mailing Address - Street 1:5706 E MOCKINGBIRD LN
Mailing Address - Street 2:STE 115-237
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5460
Mailing Address - Country:US
Mailing Address - Phone:562-644-5185
Mailing Address - Fax:
Practice Address - Street 1:5706 E MOCKINGBIRD LN
Practice Address - Street 2:STE 115-237
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5460
Practice Address - Country:US
Practice Address - Phone:562-644-5185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37173103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty