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Contact Information

AMANDA KALLSTROM FUQUA, PhD
1600 UNIVERSITY DRIVE
COLLEGE STATION, TX77840
 Phone: 979-691-3397
 Fax: 979-691-3332
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for AMANDA KALLSTROM FUQUA · (Female)

NPI Number 1427238484
Status Active
Credentials PhD
Entity Individual
Enumeration date 11/07/2007
Last updated 11/07/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • TX License # 33603
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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