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DR. CANDIDA JANE LUTES PHD

Clinical Neuropsychologist

Dallas, Texas

Provider NPI: 1952309395

Provider Information:
DR. CANDIDA JANE LUTES PHD
Gender: F
Sole Proprietor


Practice Location:
3500 OAK LAWN AVE. SUITE 275 DALLAS, TX 75219 US
Tel: 214-522-0498  Fax: 214-522-0454

Business Mailing Address:
3500 OAK LAWN AVE. SUITE 275 DALLAS, TX 75219 US
Tel: 214-522-0498  Fax: 214-522-0454

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
TX21711
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
TX21711

Other Provider Identifiers:

IssuerNumberStateType
00334369-01TX05
0334379-01TX05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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