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General NPI Number Information
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NPI Number | 1841639374
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Entity Type | Individual
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Provider Name | ANDREA RENEE KOHN LAC
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Gender | Female
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 13740 RESEARCH BLVD SUITE U-1
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City | AUSTIN
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State | TX
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Zip | 78750-1884
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Country | US
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Telephone | 512-335-5426
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Fax | 512-335-7462
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Provider Business Mailing Address
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Address Line | 9715 N FM 620 # 3207
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City | AUSTIN
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State | TX
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Zip | 78726-2256
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Country | US
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Telephone | 512-940-8162
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC01387
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License Number State | TX
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