| NPI | 1457740862 |
|---|---|
| Former Legal Business Name | DEEP EDDY PSYCHOTHERAPY, PLLC |
| Entity Type | Organization |
| Authorized Contact | GLENN R. OLDS Managing Psychologist 512-217-9579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: TX 34890) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: TX 34301) |
| 103TC0700X Psychologist, Clinical (Licence: TX 21274) | |
| 103TC1900X Psychologist, Counseling (Licence: TX 20938) | |
| 103TC1900X Psychologist, Counseling (Licence: TX 33076) | |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2022-12-27 |