Individual
DR. VIRGINIA ELLEN LIVESAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
903 FOREST ST, GEORGETOWN, TX 78626
(512) 864-9570
(512) 864-9570
Mailing address
903 FOREST ST, GEORGETOWN, TX 78626
(512) 864-9570
(512) 864-9570
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31428
TX
Other
Enumeration date
06/02/2006
Last updated
03/12/2013
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