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General NPI Number Information
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NPI Number | 1912506114
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Entity Type | Individual
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Provider Name | DANIEL ALLEN MT-BC
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Gender | Male
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 500 E SAINT JOHNS AVE
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City | AUSTIN
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State | TX
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Zip | 78752-2508
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Country | US
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Telephone | 512-961-5575
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Fax |
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Provider Business Mailing Address
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Address Line | 4008 CIMA SERENA DR UNIT A
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City | AUSTIN
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State | TX
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Zip | 78759-8110
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Country | US
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Telephone | 512-422-7367
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 12074
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License Number State | TX
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