Individual
ANNELISA HELENE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2222 WESTERN TRAILS BLVD STE 107, AUSTIN, TX 78745-1601
(512) 815-3814
Mailing address
2222 WESTERN TRAILS BLVD STE 107, AUSTIN, TX 78745-1601
(512) 815-3814
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
38061
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356589683
BCBSTX
TX
Enumeration date
01/23/2009
Last updated
06/22/2022
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