Provider Demographics
NPI:1023867116
Name:OGLE, THERESE HUDGINS (LPA, LSSP)
Entity type:Individual
Prefix:
First Name:THERESE
Middle Name:HUDGINS
Last Name:OGLE
Suffix:
Gender:F
Credentials:LPA, LSSP
Other - Prefix:
Other - First Name:THERESE
Other - Middle Name:LYNN
Other - Last Name:HUDGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1541 FARINGDON DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-2746
Mailing Address - Country:US
Mailing Address - Phone:214-808-3150
Mailing Address - Fax:
Practice Address - Street 1:1541 FARINGDON DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-2746
Practice Address - Country:US
Practice Address - Phone:214-808-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15134103TH0004X, 103TB0200X
TX6345103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool