Provider Demographics
NPI:1891888715
Name:BILLINGS, MARALYN (PHD)
Entity Type:Individual
Prefix:MS
First Name:MARALYN
Middle Name:
Last Name:BILLINGS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 81ST ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2600
Mailing Address - Country:US
Mailing Address - Phone:806-794-9672
Mailing Address - Fax:
Practice Address - Street 1:5717 66TH ST STE 120
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-799-3011
Practice Address - Fax:806-799-1494
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25362103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029458902Medicaid
TX029458902Medicaid
TXS49028Medicare UPIN