Provider Demographics
NPI:1235754201
Name:HILBERG, AMANDA MAX (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MAX
Last Name:HILBERG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:MOSKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5900 BALCONES DR STE 190
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4295
Mailing Address - Country:US
Mailing Address - Phone:512-246-7225
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 190
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4295
Practice Address - Country:US
Practice Address - Phone:512-246-7225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38444103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical