Willis, Shirley Anne
Willis, Shirley Anne is an sole proprietor health care provider with primary practice located at 2340 W Interstate 20 Bldg. Hr-Ii, Ste. 206, Arlington TX 76017-7620. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Willis, Shirley Anne can be contacted via phone (814) 466-2585.Contact Information
Primary practice address
2340 W Interstate 20 Bldg. Hr-Ii, Ste. 206
Arlington TX 76017-7620
Phone: (814) 466-2585
Fax: (817) 466-2596
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 21860 | Texas |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X |
Profile Details
| NPI number | 1023184264 |
|---|---|
| LBN Legal business name | Willis, Shirley Anne |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Mar 22nd, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023184264 | NPPES |
| Texas | MEDICAID | 096833101 | |
| Texas | Other | 00H45R |
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