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General NPI Number Information
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NPI Number | 1639280464
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Entity Type | Individual
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Provider Name | KATHRINE GRANDEY MSSW
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12871 N HIGHWAY 183 201
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City | AUSTIN
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State | TX
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Zip | 78750-3248
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Country | US
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Telephone | 512-250-9735
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Fax | 512-250-2110
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Provider Business Mailing Address
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Address Line | 12871 N HIGHWAY 183 201
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City | AUSTIN
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State | TX
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Zip | 78750-3248
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Country | US
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Telephone | 512-250-9735
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Fax | 512-250-2110
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 003315
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License Number State | TX
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