MEDICARE: MICHELLE A TEWS BCABA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	0-07-2420	TX

General Provider Information

NPI Number	:	1124341706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE A TEWS BCABA

Provider Business Mailing Address
First Line	:	3006 BEE CAVES RD STE B200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-6751
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3006 BEE CAVES RD STE B200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-6751
Country	:	US
Telephone Number	:	512-328-5599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2010
Last Update Date	:	03/10/2010

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