| Liza Potapenko Psy.d. Llc | |
|
2111 Dickson Dr Ste 10 Austin TX 78704-4788 | |
| (512) 710-7203 | |
| Not Available |
| Full Name | Liza Potapenko Psy.d. Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2111 Dickson Dr Ste 10, Austin, Texas |
| Authorized Official Name and Position | Elizaveta Potapenko (PRESIDENT) |
| Authorized Official Contact | 5127107203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liza Potapenko Psy.d. Llc 2111 Dickson Dr Ste 10 Austin TX 78704-4788 Ph: (512) 710-7203 | Liza Potapenko Psy.d. Llc 2111 Dickson Dr Ste 10 Austin TX 78704-4788 Ph: (512) 710-7203 |
| NPI Number | 1629567904 |
|---|---|
| Provider Enumeration Date | 05/02/2018 |
| Last Update Date | 05/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629567904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 36269 (Texas) | Primary |
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