DR. NANCY A DIDRIKSEN PHD
Clinical Neuropsychologist
Richardson, Texas
Provider NPI: 1316951247
Provider Information:DR. NANCY A DIDRIKSEN PHD
Gender: F
Sole Proprietor
Practice Location:
1143 ROCKINGHAM DR STE 105 RICHARDSON, TX 75080 US
Tel: 972-889-9933 Fax: 972-889-9935
Business Mailing Address:
1143 ROCKINGHAM DR STE 105 RICHARDSON, TX 75080 US
Tel: 972-889-9933 Fax: 972-889-9935
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | TX | 23529 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
OWCP INDIVIDUAL PROVIDER | 179804900 | TX | 01 |
RR MEDICARE PROVIDER # | 680009955 | TX | 01 |
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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