MEDICARE: KATHERINE UMPHRESS ALLEN 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	14115	TX

General Provider Information

NPI Number	:	1942493259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE UMPHRESS ALLEN LPC

Provider Business Mailing Address
First Line	:	1221 JUNCTION HWY
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-4905
Country	:	US
Telephone Number	:	830-329-2361
Fax Number	:	830-895-5114

Provider Business Practice Location Address
First Line	:	1221 JUNCTION HWY
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-4905
Country	:	US
Telephone Number	:	830-329-2361
Fax Number	:	830-895-5114

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

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	08/20/2007

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