Provider Demographics
NPI:1518702364
Name:SCAMPERLE, LOUISA JOLANDA (PSYD)
Entity type:Individual
Prefix:DR
First Name:LOUISA
Middle Name:JOLANDA
Last Name:SCAMPERLE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 TRAVIS ST APT 205
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1462
Mailing Address - Country:US
Mailing Address - Phone:480-694-8249
Mailing Address - Fax:
Practice Address - Street 1:16970 DALLAS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1928
Practice Address - Country:US
Practice Address - Phone:214-556-3739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39358103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical