Provider Demographics
NPI:1528413556
Name:INTEGRATION AND COHESIVENESS PRACTICE, PLLC.
Entity Type:Organization
Organization Name:INTEGRATION AND COHESIVENESS PRACTICE, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:940-453-7950
Mailing Address - Street 1:3309 PECAN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-6005
Mailing Address - Country:US
Mailing Address - Phone:940-453-7950
Mailing Address - Fax:
Practice Address - Street 1:3407 W SLAUGHTER LN
Practice Address - Street 2:SUITE A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5714
Practice Address - Country:US
Practice Address - Phone:512-522-5898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37089103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty