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General NPI Number Information
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NPI Number | 1912629072
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Entity Type | Individual
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Provider Name | MAGGIE VAN NES LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 11754 JOLLYVILLE RD STE 110
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City | AUSTIN
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State | TX
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Zip | 78759-3948
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Country | US
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Telephone | 866-912-2746
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Fax | 800-420-2305
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Provider Business Mailing Address
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Address Line | 11754 JOLLYVILLE RD STE 110
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City | AUSTIN
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State | TX
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Zip | 78759-3948
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Country | US
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Telephone | 866-912-2746
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Fax | 800-420-2305
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 108352
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License Number State | TX
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