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Organization
MY FAMILY THERAPY
Active
Organization
MY FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ANNE NERICCIO PHD-CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(512) 853-9864
Entity
Organization
Contact information
Practice address
8700 MANCHACA RD STE 101, AUSTIN, TX 78748-5372
(512) 853-9864
(866) 586-3938
Mailing address
6800 W GATE BLVD # 132-617, AUSTIN, TX 78745-4883
(512) 853-9864
(866) 586-3938
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10310
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191681904
—
TX
Enumeration date
08/15/2012
Last updated
08/15/2012
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