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General NPI Number Information
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NPI Number | 1790970143
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Entity Type | Individual
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Provider Name | SHANTI DUNCAN
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Gender | Female
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 314 E HIGHLAND MALL BLVD 508
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City | AUSTIN
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State | TX
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Zip | 78752-3735
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Country | US
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Telephone | 512-845-9080
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Fax |
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Provider Business Mailing Address
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Address Line | 12407 N MO PAC EXPY 100-285
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City | AUSTIN
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State | TX
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Zip | 78758-2475
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Country | US
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Telephone | 512-845-9080
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19787
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License Number State | TX
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