Provider Demographics
NPI:1447983911
Name:ECHOLS, DEMETRIA DANIELLE POLK (M ED)
Entity type:Individual
Prefix:
First Name:DEMETRIA
Middle Name:DANIELLE POLK
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:INSIGHT TESTING
Other - Middle Name:AND
Other - Last Name:CONSULT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:204 HITT ST.
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1206
Mailing Address - Country:US
Mailing Address - Phone:972-523-0235
Mailing Address - Fax:
Practice Address - Street 1:204 HITT ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1206
Practice Address - Country:US
Practice Address - Phone:972-523-0235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty