Provider Demographics
NPI:1417345182
Name:MIDDELBERG, LAURA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:MIDDELBERG
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 1:2901 BEE CAVES RD
Mailing Address - Street 2:BOX N
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5584
Mailing Address - Country:US
Mailing Address - Phone:512-333-0893
Mailing Address - Fax:
Practice Address - Street 1:2901 BEE CAVES RD
Practice Address - Street 2:THE ANDERSON HOUSE
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5584
Practice Address - Country:US
Practice Address - Phone:512-333-0893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool