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General NPI Number Information
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NPI Number | 1528413556
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Entity Type | Organization
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Legal Business Name | INTEGRATION AND COHESIVENESS PRACTICE, PLLC.
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Dates
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Enumeration Date | 04/27/2016
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Last Update Date | 04/27/2016
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Provider Practice Location Address
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Address Line | 3407 W SLAUGHTER LN SUITE A
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City | AUSTIN
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State | TX
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Zip | 78748-5714
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Country | US
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Telephone | 512-522-5898
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Fax |
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Provider Business Mailing Address
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Address Line | 3309 PECAN SPRINGS RD
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City | AUSTIN
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State | TX
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Zip | 78723-6005
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Country | US
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Telephone | 940-453-7950
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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 | DR. LAURA A. CARDONA
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Credential | PH.D.
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Telephone | 940-453-7950
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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 | 37089
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License Number State | TX
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