Provider Demographics
NPI:1528417540
Name:VERDONE, ANTOINETTE (ATP)
Entity Type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:
Last Name:VERDONE
Suffix:
Gender:F
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 W BRAKER LN
Mailing Address - Street 2:SUITE 300-424
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-7853
Mailing Address - Country:US
Mailing Address - Phone:512-522-1705
Mailing Address - Fax:888-501-1009
Practice Address - Street 1:3310 W BRAKER LN
Practice Address - Street 2:SUITE 300-424
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-7853
Practice Address - Country:US
Practice Address - Phone:512-522-1705
Practice Address - Fax:888-501-1009
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4835174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist