MEDICARE: ELIZABETH ANNE DOSSMAN 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	64134	TX

General Provider Information

NPI Number	:	1447562657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANNE DOSSMAN LPC

Provider Business Mailing Address
First Line	:	1631 E 2ND ST
Second Line	:	BLDG E
City	:	AUSTIN
State	:	TX
Zip	:	78702-4490
Country	:	US
Telephone Number	:	512-804-3650
Fax Number	:	512-476-0217

Provider Business Practice Location Address
First Line	:	1631 E 2ND ST
Second Line	:	BLDG E
City	:	AUSTIN
State	:	TX
Zip	:	78702-4490
Country	:	US
Telephone Number	:	512-804-3650
Fax Number	:	512-476-0217

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

Provider Enumeration Date	:	07/06/2010
Last Update Date	:	07/06/2010

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