Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 33371 | TX |
N | 103T00000X | Psychologist | 33371 | TX |
Y | 103TC1900X | Counseling Psychologist | 33371 | TX |
N | 103TF0000X | Family Psychologist | 33371 | TX |
N | 103TP2701X | Group Psychotherapist | 33371 | TX |
NPI | 1093904781 |
---|---|
Provider Name | Dr. Jean Mauriello Germain |
First Address | Austin, TX 78703-0038 |
Second Address | Austin, TX 78703-4555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2007 |
Last Update Date | 17/10/2007 |