Organization
LIZA POTAPENKO PSY.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZAVETA POTAPENKO PSY.D. (PRESIDENT)
(512) 710-7203
Entity
Organization
Contact information
Practice address
2111 DICKSON DR STE 10, AUSTIN, TX 78704-4788
(512) 710-7203
Mailing address
2111 DICKSON DR STE 10, AUSTIN, TX 78704-4788
(512) 710-7203
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
36269
TX
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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