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General NPI Number Information
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NPI Number | 1790143030
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Entity Type | Organization
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Legal Business Name | AUSTIN PSYCHOTHERAPY & TRAINING CENTER
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Dates
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Enumeration Date | 02/02/2016
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 12234 SHADOW CREEK PKWY SUITE 1108
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City | PEARLAND
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State | TX
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Zip | 77584-7330
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Country | US
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Telephone | 281-433-4649
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Fax |
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Provider Business Mailing Address
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Address Line | 3907 BRADEN DR N
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City | HOUSTON
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State | TX
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Zip | 77047-6796
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Country | US
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Telephone | 281-433-4649
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VANESSA KAY AUSTIN
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Credential | LPC-S
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Telephone | 281-433-4649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 15135
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License Number State | TX
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