Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 36567 | TX |
Y | 103T00000X | Psychologist | 36567 | TX |
NPI | 1003314451 |
---|---|
Provider Name | Anna Claire Allen |
First Address | Austin, TX 78745-7475 |
Second Address | Austin, TX 78745-7475 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2018 |
Last Update Date | 30/01/2018 |