MEDICARE: MS. DEBRA ALEXANDER AUSTIN LCSW

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	174400000X	Specialist	1559	LA

General Provider Information

NPI Number	:	1790063915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA ALEXANDER AUSTIN LCSW

Provider Business Mailing Address
First Line	:	4445 DALE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-4036
Country	:	US
Telephone Number	:	504-214-8968
Fax Number	:	504-304-2682

Provider Business Practice Location Address
First Line	:	4445 DALE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-4036
Country	:	US
Telephone Number	:	504-214-8968
Fax Number	:	504-304-2682

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

Provider Enumeration Date	:	07/22/2011
Last Update Date	:	07/22/2011

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