Healthcare Provider Details
I. General information
NPI: 1639444540
Provider Name (Legal Business Name): JESSICA ABEL CHONIS CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/12/2012
Last Update Date: 03/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6811 AUSTIN CENTER BLVD SUITE 400
AUSTIN TX
78731-3146
US
IV. Provider business mailing address
6811 AUSTIN CENTER BLVD SUITE 400
AUSTIN TX
78731-3146
US
V. Phone/Fax
- Phone: 512-628-1926
- Fax: 512-628-1841
- Phone: 512-628-1926
- Fax: 512-628-1841
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 170300000X |
| Taxonomy | Genetic Counselor (M.S.) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: