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Individual

DR. SUSAN ANSORGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
3908 RIDGELEA DR, AUSTIN, TX 78731-6127
(512) 797-3654
(512) 391-9021
Mailing address
3908 RIDGELEA DR, AUSTIN, TX 78731-6127
(512) 797-3654
(512) 391-9021

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
25813
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
337652
VALUEOPTIONS
TX
01
75GJ
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/08/2007
Last updated
10/14/2022
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