MEDICARE: CON ALMA THERAPY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1023574761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CON ALMA THERAPY, PLLC

Provider Business Mailing Address
First Line	:	2222 WESTERN TRAILS BLVD STE 107
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-1601
Country	:	US
Telephone Number	:	512-686-7525
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 WESTERN TRAILS BLVD STE 107
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-1601
Country	:	US
Telephone Number	:	512-686-7525
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ALICIA ENCISO LITSCHI
Credential	:	PSYCHOLOGIST, PHD
Telephone Number	:	512-686-7525

Provider Enumeration Date	:	02/19/2019
Last Update Date	:	02/19/2019

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