Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 38457 | TX |
Y | 103TC0700X | Clinical Psychologist | 38457 | TX |
N | 102L00000X | Psychologist | 38457 | TX |
N | 103T00000X | Psychologist | 38457 | TX |
N | 103G00000X | Clinical Psychologist | 38457 | TX |
N | 103TC0700X | Clinical Psychologist | 38457 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 38457 | TX |
N | 103TR0400X | Rehabilitation Psychologist | 38457 | TX |
N | 103TS0200X | School Psychologist | 38457 | TX |
NPI | 1124791140 |
---|---|
Provider Name | Alexandra Lin Elliot |
First Address | Austin, TX 78732-6088 |
Second Address | Austin, TX 78732-6088 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2021 |
Last Update Date | 26/07/2021 |