Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 37098 | TX |
NPI | 1073969507 |
---|---|
Provider Name | Dr. Alicia Enciso Litschi |
First Address | Austin, TX 78702-5310 |
Second Address | Austin, TX 78702-3325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2016 |
Last Update Date | 13/05/2016 |