Provider Demographics
NPI:1174672091
Name:BIEBERICH, ANDREA ALLENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ALLENE
Last Name:BIEBERICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 PARKSTONE HEIGHTS DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7396
Mailing Address - Country:US
Mailing Address - Phone:512-627-6259
Mailing Address - Fax:
Practice Address - Street 1:4101 PARKSTONE HEIGHTS DR
Practice Address - Street 2:SUITE 260
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7396
Practice Address - Country:US
Practice Address - Phone:512-627-6259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4190103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical