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General NPI Number Information
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NPI Number | 1013643584
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Entity Type | Organization
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Legal Business Name | ROBERTA TARGINO, PLLC
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 4209 GANDARA BND
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City | AUSTIN
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State | TX
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Zip | 78738-6781
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Country | US
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Telephone | 737-637-1360
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Fax |
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Provider Business Mailing Address
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Address Line | 4209 GANDARA BND
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City | AUSTIN
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State | TX
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Zip | 78738-6781
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Country | US
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Telephone | 904-629-3776
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | ROBERTA TARGINO
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Credential | LPC-TX, LMHC-FL
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Telephone | 904-629-3776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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