Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 33629 | TX |
Y | 103TC0700X | Clinical Psychologist | 33629 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 33629 | TX |
N | 103TP2701X | Group Psychotherapist | 33629 | TX |
NPI | 1003013053 |
---|---|
Provider Name | Dr. Kristie Dawn Engel |
First Address | Cedar Park, TX 78630-2135 |
Second Address | Austin, TX 78738-6468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 02/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003013053 | (05) | TX |
33629 | TX STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS (01) | TX |