MEDICARE: DONNA PFEFFER MED, LPC

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	101Y00000X	Counselor	64346	TX

General Provider Information

NPI Number	:	1154692895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA PFEFFER MED, LPC

Provider Business Mailing Address
First Line	:	2702 ALLANDALE RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-1008
Country	:	US
Telephone Number	:	512-917-5922
Fax Number	:

Provider Business Practice Location Address
First Line	:	3409 EXECUTIVE CENTER DR STE 210
Second Line	:	BUCHANAN BUILDING
City	:	AUSTIN
State	:	TX
Zip	:	78731-1641
Country	:	US
Telephone Number	:	512-917-5922
Fax Number	:

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

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	01/25/2012

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