MEDICARE: ALISON PELZ

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	1041C0700X	Clinical Social Worker	40198	TX

General Provider Information

NPI Number	:	1215186762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALISON PELZ

Provider Business Mailing Address
First Line	:	10608 AMES LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78739-1533
Country	:	US
Telephone Number	:	512-293-5770
Fax Number	:

Provider Business Practice Location Address
First Line	:	604 W 9TH ST
Second Line	:	SUITE B
City	:	AUSTIN
State	:	TX
Zip	:	78701-2212
Country	:	US
Telephone Number	:	512-293-5770
Fax Number	:

Authorized Official
Title or Position	:	SOCIAL WORKER
Name	:	ALISON K PELZ
Credential	:	LCSW
Telephone Number	:	512-293-5770

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	09/09/2008

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