Provider Demographics
NPI:1285449843
Name:ONE LIFE CHILD DEVELOPMENT CENTER, PLLC
Entity type:Organization
Organization Name:ONE LIFE CHILD DEVELOPMENT CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PILLAT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-536-6992
Mailing Address - Street 1:5246 FARQUHAR LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-2202
Mailing Address - Country:US
Mailing Address - Phone:214-908-6916
Mailing Address - Fax:
Practice Address - Street 1:4100 SPRING VALLEY RD STE 930
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-3755
Practice Address - Country:US
Practice Address - Phone:214-536-6992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health