MEDICARE: MS. PAULA JAN HYATT 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	101YP2500X	Professional Counselor	64266	TX

General Provider Information

NPI Number	:	1770803009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAULA JAN HYATT LPC

Provider Business Mailing Address
First Line	:	8500 N MOPAC EXPY
Second Line	:	501
City	:	AUSTIN
State	:	TX
Zip	:	78759-8375
Country	:	US
Telephone Number	:	512-567-9293
Fax Number	:	512-691-9007

Provider Business Practice Location Address
First Line	:	8500 N MOPAC EXPY
Second Line	:	501
City	:	AUSTIN
State	:	TX
Zip	:	78759-8375
Country	:	US
Telephone Number	:	512-567-9293
Fax Number	:	512-691-9007

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

Provider Enumeration Date	:	06/09/2010
Last Update Date	:	06/09/2010

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