Individual
TELISA L CLEVENGER-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
4534 WESTGATE BLVD, SUITE 112, AUSTIN, TX 78745-1485
(512) 963-7404
Mailing address
4534 WESTGATE BLVD, SUITE 112, AUSTIN, TX 78745-1485
(512) 963-7404
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
201468
TX
Other
Enumeration date
12/24/2009
Last updated
12/24/2009
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