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General NPI Number Information
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NPI Number | 1245435205
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Entity Type | Organization
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Legal Business Name | ANDREA BIEBERICH, PH.D., LP, PLLC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 02/15/2014
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Provider Practice Location Address
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Address Line | 5000 BEE CAVES RD SUITE 100
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5266
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Country | US
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Telephone | 512-627-6259
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 BEE CAVES RD SUITE 100
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5266
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Country | US
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Telephone | 512-627-6259
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | ANDREA BIEBERICH
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Credential | PH.D.
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Telephone | 512-627-6259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4190
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 4190
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License Number State | MN
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