Provider Demographics
NPI:1417639691
Name:VERZIJL, CHRISTINA LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LEE
Last Name:VERZIJL
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 1:9200 TEXAS OAKS DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6330
Mailing Address - Country:US
Mailing Address - Phone:210-394-1351
Mailing Address - Fax:
Practice Address - Street 1:9200 TEXAS OAKS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6330
Practice Address - Country:US
Practice Address - Phone:210-394-1351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39779103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical