Provider Demographics
NPI:1861668246
Name:FLETCHER & ASSOCIATES PSYCHOLOGICAL SERVICES, P.A.
Entity Type:Organization
Organization Name:FLETCHER & ASSOCIATES PSYCHOLOGICAL SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:HENDERSON
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-612-1188
Mailing Address - Street 1:2301 OHIO DR STE 135
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3992
Mailing Address - Country:US
Mailing Address - Phone:972-612-1188
Mailing Address - Fax:
Practice Address - Street 1:2301 OHIO DR STE 135
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3992
Practice Address - Country:US
Practice Address - Phone:972-612-1188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26858103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX44612OtherNATIONAL HEALTH SERVICE PROVIDER