Individual
EVGENIYA AGAEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2419 BURLESON CT, SIDE B, AUSTIN, TX 78741-5603
(512) 828-1934
Mailing address
2419 BURLESON CT, SIDE B, AUSTIN, TX 78741-5603
(512) 828-1934
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
69359
TX
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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