Liza Potapenko Psy.D. LLC
Clinic/Center, Adult Mental Health in Austin, TX. Organization (NPI-2).
NPI number1629567904
StatusActive
Last updated in NPPESMay 2, 2018
Details
- NPI
- 1629567904
- Entity type
- Organization (NPI-2)
- Legal business name
- Liza Potapenko Psy.D. LLC
- Organization subpart
- No
- Enumeration date
- May 2, 2018
- Last updated
- May 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | 36269 | TX | Yes |
Practice location
2111 Dickson Dr Ste 10Austin, TX 78704-4788
Phone 512-710-7203
Mailing address
2111 Dickson Dr Ste 10Austin, TX 78704-4788
Phone 512-710-7203
Authorized official
Elizaveta Potapenko
President
5127107203
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