Individual
LIEF ERICSSON FENNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1601 TRINITY STREET, BLDG. B, HDB 3, Z0600, AUSTIN, TX 78712-1419
(833) 882-2737
Mailing address
1601 TRINITY STREET, BLDG. B, HDB 3, Z0600, AUSTIN, TX 78712-1419
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
A151030
CA
2084P0800X
Psychiatry Physician
Primary
T5132
TX
2084P0802X
Addiction Psychiatry Physician
A151030
CA
Other
Enumeration date
03/23/2016
Last updated
02/19/2022
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