Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 32811 | TX |
N | 103TC0700X | Clinical Psychologist | 32811 | TX |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 32811 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 32811 | TX |
Y | 103G00000X | Clinical Psychologist | 32811 | TX |
Y | 103TC0700X | Clinical Psychologist | 32811 | TX |
NPI | 1184875874 |
---|---|
Provider Name | Dr. Deborah L Stote |
First Address | Austin, TX 78712-1043 |
Second Address | Austin, TX 78712-1043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 01/10/2008 |