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General NPI Number Information
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NPI Number | 1770613499
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Entity Type | Individual
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Provider Name | ROBERT EDWARD THURLOW LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2001 CHICON ST
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City | AUSTIN
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State | TX
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Zip | 78722-2428
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Country | US
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Telephone | 512-735-2137
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Fax |
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Provider Business Mailing Address
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Address Line | 3209 S IH-35 #2029
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City | AUSTIN
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State | TX
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Zip | 78741
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Country | US
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Telephone | 512-326-2532
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Fax |
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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 | 31305
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License Number State | TX
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