Provider Demographics
NPI:1740563279
Name:MA, CLAUDIA (PHD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:MA
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 1:300 S LAMAR BLVD APT 201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-1089
Mailing Address - Country:US
Mailing Address - Phone:803-727-8632
Mailing Address - Fax:
Practice Address - Street 1:2499 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:SUITE B-201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7762
Practice Address - Country:US
Practice Address - Phone:803-727-8632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35170103T00000X
NY018617103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist