Austin Therapy South, Pllc | |
10816 Crown Colony Dr Ste 211 Austin TX 78747-1677 | |
(512) 588-3088 | |
Not Available |
Full Name | Austin Therapy South, Pllc |
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Speciality | Social Worker |
Location | 10816 Crown Colony Dr Ste 211, Austin, Texas |
Authorized Official Name and Position | Tamela Malone (OWNER) |
Authorized Official Contact | 5125883088 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Austin Therapy South, Pllc 10816 Crown Colony Dr Ste 211 Austin TX 78747-1677 Ph: (512) 588-3088 | Austin Therapy South, Pllc 10816 Crown Colony Dr Ste 211 Austin TX 78747-1677 Ph: (512) 588-3088 |
NPI Number | 1073157061 |
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Provider Enumeration Date | 11/01/2019 |
Last Update Date | 11/01/2019 |
Medicare PECOS PAC ID | 8426483595 |
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Medicare Enrollment ID | O20200117001271 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073157061 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Tamela S. Malone |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1952627846 PECOS PAC ID: 9335574409 Enrollment ID: I20200117001355 |
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