Individual
DR. STEPHANIE BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3006 BEE CAVES RD STE D310, ROLLINGWOOD, TX 78746-5753
(512) 956-4011
Mailing address
8003 S IH 35 APT 2724, AUSTIN, TX 78744-0089
(562) 212-3944
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
39141
TX
103TC1900X
Counseling Psychologist
Primary
39141
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/27/2016
Last updated
05/24/2023
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